Bruce H.Knox
Independent Scholar, New Zealand
Publications
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Review Article
Exercise Intolerance in Post-Viral and Post-Surgical Dysautonomia: A Lived Experience with Mechanistic Insight and Recovery Trajectory
Author(s): Bruce H.Knox*
Background: Exercise intolerance is a defining and debilitating feature of dysautonomia, particularly in post-viral and post- surgical states. It reflects impaired autonomic regulation of cardiovascular and metabolic responses to exertion, often driven by small-fiber neuropathy, baroreflex dysfunction, and cardiac denervation. Case Presentation: I present a lived experience of profound exercise intolerance following a cumulative “three-hit” injury: Chikungunya virus infection, cardiac tamponade, and emergency open-heart surgery. This sequence resulted in severe autonomic dysfunction, including chronotropic incompetence, orthostatic hypotension, and gastroparesis. For several years, my heart rate remained fixed at approximately 70 bpm, irrespective of exertion, rendering meaningful physical activity impossible. D.. Read More»