Symptom complex characterized by dyspnea , dizziness , mental and physical fatigue, chest pain and palpitations.
Etiology
Neurocirculatory asthenia is a psychosomatic disorder with a predominance of cardiovascular symptoms. It is more common in women. It usually appears after twenty years of age, in people subjected to conscious or subconscious stress; for example, on the front lines or due to the death of a relative due to heart disease. The symptoms are due to an imbalance of the autonomic nervous system. The disorder is associated with a physical constitution and an asthenic temperament.
Symptoms and Diagnosis
Without obvious and objective evidence of organic heart disease, palpitations, tachycardia, chest pain, dyspnea, vertigo, physical and physical mental fatigue, and functional arrhythmias appear. He may also have been apprehensive, trembling, restless and anxious, substernal pain is rare; instead, the patient feels dull, recurrent, nonradiated pain in the left chest . Distracting the patient can suppress the pain, even in the middle of an attack.
Vasomotor disorders – vertigo, flares, and coldness and sweating of the extremities – indicate an imbalance of the autonomic nervous system due to emotion rather than exertion. Respiratory effort is usually accompanied by sighing and must be distinguished from true dyspnea. Other symptoms such as headaches, gastrointestinal disorders , myalgia and arthralgia, are frequent and, by suggestion, may temporarily become the center of attention.
The vital capacity may be reduced. The respiratory retention time is short (twenty seconds or less) and is not prolonged, not even with O² breathing. Fluoroscopic and electrocardiographic examination is usually normal. This disorder must be distinguished from rheumatic heart disease, tuberculosis, brucellosis, hyperthyroidism, and orthostatic hypotension. The anxiety of patients with organic heart disease can produce symptoms similar to those of neurocirculatory asthenia.
Prognosis and treatment
Organic heart diseases do not develop, starting from neurocirculatory asthenia. The course is long, unless the basic psychogenic disorder is corrected soon. A partial or total understanding of the nature of the stress phenomena that produce the clinical picture can serve to reduce its intensity. A life plan must be ordered that avoids the stress that can precipitate a relapse. Dietary treatment is very important, since by default anorexia and great weight loss can occur. In a palliative sense, phenobarbital at a dose of 30 mg orally three times a day, or reserpine, 0.25 mg orally at similar intervals, can allay anxiety.