Cardioneurosis
Cardioneurosis is a dysfunction of normal cardiac activity, accompanied by psychosomatic disorders due to the development of an imbalance between processes occurring in the cerebral cortex and hypothalamic regulatory centers.
It is impossible to establish the statistical data of the incidence of cardioneurosis reliably, since this pathology is difficult to diagnose and most cases of cardioneurosis remain unrecognized.
This psychosomatic pathology belongs to the category of psychosomatic diseases, therefore, a group of specialists, as part of a cardiologist, neurologist and psychiatrist, should be treating patients suffering from cardioneurosis.
Causes of cardioneurosis
In the development of cardioneurosis, the main etiopathogenetic link is the imperfection of the functioning of the autonomic nervous system, arising for various reasons and having unified clinical manifestations in the form of psychological discomfort and the appearance of atypical physiological sensations.
Provocateur of the onset of an attack of cardioneurosis is a factor of stressful action on the body. Not always signs of cardioneurosis are manifested under the influence of a negative stress factor, even joyful emotions can cause an attack. In this regard, people suffering from psycho-emotional disorders are more likely than others to develop the clinical and morphological changes characteristic of cardioneurosis.
However, in some cases, the attack of cardioneurosis can develop against the background of complete well-being in persons who do not suffer from organic pathology of the heart. In this situation, even the slightest changes in the mode of work and rest, as well as eating disorders in the form of short-term alcohol abuse and consumption of foods containing caffeine in more than usual quantities, are important.
The physical activity of a patient is of great importance in the development of cardioneurosis symptoms. People who systematically engage in sports and prefer an active pastime rarely suffer from such a pathology as cardioneurosis.
The risk group for this disease is young people with psycho-emotional disorders of varying degrees, elderly people with signs of progressive dementia in the form of Alzheimer's disease, as well as patients with diagnosed organic pathology of the cardiovascular system( myocarditis, developmental anomalies and rheumatism).
There is a clear correlation between the progression of cardioneurosis signs and episodes of acute viral respiratory infection. Thus, patients with influenza in an acute period can present typical complaints typical of cardioneurosis. In this regard, all patients who underwent a viral infection in the recovery period recommended the use of complex bracing multivitamin complexes containing magnesium and B vitamins, which contribute to the improvement of the functioning of neurohumoral regulation structures.
Symptoms of cardioneurosis
The main complaint of patients suffering from cardioneurosis is a pain syndrome in the projection of the anterior chest wall of various prevalence and severity. Most often, patients describe the pain syndrome as "acute short-term daggerache in the heart area", accompanied by a palpitation, after which a sharp increase in heart rate is observed.
In addition to complaints about interruptions in the cardiovascular system, patients note respiratory disorders in the form of an attack of suffocation and the inability to take a full breath. Some patients experience a short-term increase in body temperature without any signs of inflammation in the body.
A panic attack that occurs on the background of cardialgia is accompanied by intense sweating and a persistent cooling of the skin, a sensation of tingling in the distal parts of the limbs, which indicates the dysfunction of the autonomic nervous system.
Thus, for all patients with cardioneurosis is characterized by a wavy course of the disease with frequently changing periods of occurrence of an attack and a phase of full well-being. A typical cardio-neurotic attack is the appearance of a symptomatic complex of cardiac and extracardial nature, accompanied by the onset of panic and fear for the safety of one's own life.
With prolonged cardioneurosis the patient develops a depressive psychosis with the formation of anxious obsessions, as well as pronounced dysthymic disorders. Dysthymia manifests itself in the absence of all kinds of craving, sleep disorders with a propensity for insomnia and a complete lack of appetite. Patients suffering from dysthymic disorders in the background of cardioneurosis are not critical to their own oppressed state of the psycho-emotional sphere, since they concentrate their entire attention on the pain syndrome.
A characteristic component of a cardio-neurotic attack is an increase in the muscular tone of skeletal muscles, both in a limited area of the trunk, and in general muscular stiffness.
In the interictal period, patients with cardioneurosis may note a violation of all sensitivities in various parts of the body, as well as symptoms of circulatory disorders in the system of cerebral blood vessels( headache until the onset of migraine attacks, decreased ability to work and pronounced weakness, hot flashes of dizziness).
In order to correctly diagnose "cardioneurosis", the patient must have four absolute criteria in the form:
- the periodic occurrence of cardio-neurotic seizures for at least three months;
- a clear dependence of the development of the attack on the periods of hormonal disorders at pubertal age, as well as during pregnancy and the onset of menopause;
- presence of signs of the vegeto-vascular component in the patient;
- absence of signs of cardiac dysfunction and organic damage to the myocardium during registration of electrocardiography and echocardioscopy.
The debut of cardioneurosis occurs most often in the early prepubertal period or in the elderly, against the background of severe vascular disorders. The onset of the disease is always acute, with a clear dependence on the impact of the stress agent.
Treatment of cardioneurosis
To determine the correct and appropriate tactics for managing patients with cardioneurosis, timely diagnostics of the underlying disease is very important. Serious concern should be given to the diagnosis and treatment of patients in this category, since despite the complete absence of organic damage to the organs of the cardiovascular system, there are reliable facts of the lethal outcome of the disease.
In the diagnosis of cardioneurosis it is recommended to apply the method of elimination, that is, in order to establish the correct diagnosis, it is necessary to thoroughly examine the patient using all possible methods for diagnosing organic pathologies of the heart. Only a complete absence of diseases of the cardiovascular system of organic nature, allows us to establish the diagnosis of cardioneurosis.
Despite the fact that this pathology is a separate nosological unit related to diseases of the cardiovascular system, treatment of it in most cases does not require medical correction. In the initial conversation with the patient, priority should be given to the psychological readiness of the patient for long-term treatment and a long rehabilitation period.
The initial stages of cardioneurosis treatment are the normalization of the patient's work and rest regime with the complete exclusion of excessive physical activity. Of great importance in the correction of the patient's behavior is the establishment of a sufficient duration of night sleep, which in some cases is possible only using hypnotics and sedatives of plant origin( Sedasen 1 capsule 3 times a day).
For effective treatment of patients with cardioneurosis, the elimination of factors provoking the development of seizures plays a decisive role, and therefore, the use of various methods of psychocorrection with the aim of normalizing the microclimate in the family and the surrounding environment is recommended.
A good therapeutic calming effect for cardioneurosis is the methods of physiotherapy( manual massage, acupuncture, stone therapy).
Separately, we should consider the algorithm of measures necessary for the manifestations of a cardio-neurotic attack. First of all, it is necessary to provide the patient with complete peace and eliminate the factors that provoked the attack. The patient should be laid on a horizontal surface and provide free access to fresh air. Be sure to perform an objective examination of the patient by palpation of the pulse, auscultation of cardiac tones and percussion of the borders of cardiac dullness, since the symptoms of cardioneurosis can be observed in other organic pathologies of the heart. Among instrumental diagnostic methods, preference should be given to recording electrocardiography, which allows excluding ischemic changes in the myocardium. To eliminate the sense of anxiety, you need to apply any sedative quickly( Corvalol 20 drops).
During the rehabilitation period, special attention is paid to the correction of the patient's eating behavior, which he must observe throughout his life. To normalize the functioning of brain structures, a necessary condition is the enrichment of the body with vitamins of group B and magnesium, and therefore, the diet should consistently contain beans, nuts and greens in sufficient quantities. At the expressed insufficiency of vitamins, confirmed by laboratory methods of diagnostics, the appointment of complex vitamin preparations( magnesium B6 on 2 tablets three times a day) is shown.
Medication correction of neuroses is used in the case of a severe course of the disease, greatly aggravating the patient's condition. When choosing drugs for the treatment of cardioneurosis, it is necessary to take into account the pathogenetic form of the disease. So, people suffering from hypersthenic type of cardioneurosis, it is expedient to prescribe a long course of drugs that raise the threshold of excitability( Amizil 0.001 mg 3 times a day).Correction of the hyposthenic type of cardioneurosis is carried out by using drugs that have a stimulating effect on the central nervous system( diazepam in a daily dose of 2 mg).
A good therapeutic effect for the prevention of neurosis-like conditions is the long-term use of hypnotics in a minimal therapeutic dose( Eunotin 2.5 mg a few hours before sleep).
Consequences of cardioneurosis
Due to the fact that cardioneurosis belongs to the category of pathologies that have a chronic recurrent course, there is no one hundred percent guarantee of complete disposal of its symptoms. Cardiologists recommend patients with a tendency to develop this pathology, with special attention to the changes in the state of the body, and during the manifestations of the first signs of cardioneurosis go to a cardiac hospital for qualified help.
Transition of the disease to a chronic, recurrent course is observed in patients who do not regularly follow the doctor's recommendations for correcting the physical activity and eating behavior. In such patients, the course of cardioneurosis takes a severe course with the addition of signs of myocardial damage( attacks of stenocardic pain, hypertrophic cardiomyopathy).