Cardiac Neurosis: Understanding the Condition

Introduction

Cardiac neurosis, also known as neurocirculatory asthenia or Da Costa’s syndrome, is a functional heart disorder where a patient experiences heart-related symptoms without any structural heart disease. It is often linked to anxiety, stress, and autonomic nervous system dysfunction.

Causes and Risk Factors

Cardiac neurosis is not caused by organic heart disease but rather by: - Chronic stress and emotional distress - Panic disorder and generalized anxiety disorder - Autonomic nervous system dysfunction , leading to exaggerated heart responses - Hormonal imbalances affecting sympathetic nervous system activity - Lifestyle factors , such as lack of exercise, poor sleep, and excessive caffeine or alcohol consumption

Symptoms

Patients may experience: - Palpitations (rapid heartbeats) - Chest pain or discomfort - Shortness of breath - Dizziness or lightheadedness - Excessive sweating - Fatigue and a sense of fainting - A feeling of impending doom or fear of having a heart attack, despite normal heart function

Diagnosis

Diagnosis is typically made by excluding organic heart disease. Common diagnostic tests include: - Electrocardiogram (ECG) to rule out arrhythmias - Echocardiography to assess heart structure - Holter monitoring for detecting irregular heartbeats - Exercise stress test to observe heart response during physical activity - Psychological assessment to assess anxiety and stress levels

Treatment and Management

Since cardiac neurosis is primarily linked to anxiety and stress, treatment focuses on: 1. Education and Reassurance - Patients should understand that their symptoms are not due to a serious heart condition. - Cognitive-behavioral therapy (CBT) can help manage anxiety and stress. 2. Lifestyle Changes - Regular exercise (such as walking, yoga, or swimming) to reduce stress. - Balanced diet , avoiding excessive caffeine, alcohol, and processed foods. - Improved sleep hygiene to ensure adequate rest. 3. Medications (if required) - Beta-blockers may be used in selected cases to control palpitations. - Anti-anxiety medications or selective serotonin reuptake inhibitors (SSRIs) may be prescribed if anxiety disorders are present. 4. Relaxation Techniques - Deep breathing exercises, meditation, and progressive muscle relaxation can help control autonomic nervous system activity.

Conclusion

Cardiac neurosis is a distressing condition but not life-threatening. With proper lifestyle modifications, psychological support, and, if necessary, medications, patients can effectively manage their symptoms and improve their quality of life.

References

For more information, refer to clinical guidelines:

Source recommendations

1. European Society of Cardiology Guidelines

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
2. https://academic.oup.com/eurheartj/article/42/34/3227/6358713
3. https://www.escardio.org/Guidelines
4. https://academic.oup.com/eurheartj/article/44/39/4043/7238227
5. https://www.escardio.org/

2. American Heart Association Guidelines on Stress and Cardiovascular Disease

1. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/stress-and-heart-health
2. https://www.ahajournals.org/doi/10.1161/cir.0000000000000678
3. https://www.heart.org/
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001168
5. https://www.heart.org/en/news/2020/02/04/chronic-stress-can-cause-heart-trouble