Asthenia (fatigue) is one of the most common reasons for consultations. The term encompasses a variety of subjective sensations (tiredness, lack of energy, etc.). Many diseases are manifested initially by asthenia. We distinguish organic asthenia, psychiatric (depression, anxiety, PTSD) and reactive (isolated).
Clinical examination should include:
– The fact of occurrence: progressive or brutal, old or new, isolated or associated with other signs or special circumstances (work, intense activity, travel, illness).
– The nature of the fatigue: physical, intellectual, sexual; its occurrence in the morning (usually of psychological origin) or evening, which focuses more towards an organic cause.
– The associated clinical signs:
• the existence of general signs associated (loss of appetite, weight loss, fever) attests to a probable organic origin;
• the association of clinical signs corresponding to a particular organ precise etiology: cough and hemoptysis in tuberculosis, dyspnea in heart failure or anemia, abdominal pain parasites, jaundice hepatitis, etc;
• the association of sleep disorders, anorexia, behavior disorders, sad, slow, should suggest a depressive episode.
– Clinical examination will review:
• nutritional status: weight, signs of vitamin deficiency, anemia, etc. ;
• cardiopulmonary device: blood pressure, pulse, auscultation;
• the digestive tract;
• spleen, liver, lymph nodes;
• the state of the mucous membranes and skin;
• psychological state (anxiety, depression).
– Weakness is associated with a syndrome responds to a question that must be treated as such (that it is organic or psychiatric).
– Asthenia is isolated. She often reflects personal difficulties, relationship, etc. A listening time can relieve these patients.