Cardiac neurosis

In daily life, we often hear about mentally ill patients. These patients are relatively pitiful. Because the patient's nerves may be traumatized, this is also true for diseases such as cardiac neurosis. If the patient is in a depressing and stressful environment for a long time, it will easily cause the disease to develop further, so the patient must learn to relax himself in daily life.

People with cardiac neurosis are prone to physical incoordination. The nerves of these patients are under mental suppression for a long time, which can easily cause nerve lesions over time and lead to the occurrence of the disease. Therefore, if you can communicate more with patients in daily life, you can alleviate the symptoms of the disease.

1 Causes

Due to the influence of anxiety, tension, emotional excitement, mental trauma and other factors, the central excitation and inhibition processes are disturbed, and the cardiovascular system regulated by the autonomic nervous system also becomes disordered, causing a series of symptoms of excessive sympathetic nerve tension. In addition, excessive fatigue, too little physical activity, and lack of proper exercise of the circulatory system result in the inability to adapt to the slightest activity or fatigue, thus producing excessive cardiovascular response and causing this disease.

2 Clinical manifestations

It is more common in young and middle-aged women, with a variety of cardiovascular symptoms, which may be mild or severe but are usually not serious. There is usually no evidence of organic heart disease, but it may exist at the same time as organic heart disease or occur on the basis of the latter. The medical history should include detailed inquiries about whether there are any triggers such as anxiety, emotional excitement, mental trauma or excessive fatigue, whether the patient has ever been diagnosed with "heart disease", the relationship between sensations such as palpitations, shortness of breath or precordial discomfort and activities, fatigue and mood, sleep conditions, etc.

3. Inspection

The electrocardiogram often shows sinus tachycardia. Some patients have ST segment depression or horizontal depression, flat, biphasic or inverted T waves, which often appear in leads II, III, aVF or V4-6 and often change. The propranolol test is positive. Some patients had positive exercise tests, but their ST segments and T waves returned to normal during the "propranolol exercise test". Cardiac ultrasound can rule out structural abnormalities of the heart, great vessels, and valves.

4 Diagnosis

1. Medical history and symptoms

Clinical manifestations, previous cardiac examination results, medication history, and efficacy can help make the diagnosis.

2. Physical examination findings

Physical examination often reveals no special findings. They are often in an anxious state or with a nervous expression, and their blood pressure may be normal or slightly elevated. Auscultation of the heart may reveal an increased heart rate and enhanced heart sounds, accompanied by a soft grade I-II systolic murmur in the precordial area and occasional premature beats.

5 Differential Diagnosis

The diagnosis of cardiac neurosis must be made on the basis of excluding organic heart disease, and caution should be exercised when making the diagnosis. Endocrine diseases such as hyperthyroidism, pheochromocytoma and organic heart diseases such as coronary heart disease, cardiomyopathy or viral myocarditis should be excluded. Chest discomfort in patients with coronary heart disease is often related to activity or physical labor, with a negative propranolol test and a positive exercise test. Patients with cardiomyopathy have positive findings on cardiac ultrasound examinations. Patients with viral myocarditis often have a history of upper respiratory tract infection, and elevated serum myocardial enzymes in the acute phase can be used for differentiation.

6 Treatment

1. Psychotherapy

(1) Make the patient understand the nature of the disease to relieve his or her concerns and convince him or her that there is no organic cardiovascular disease;

(2) Medical staff must be patient with patients in order to gain their trust and cooperation;

(3) Avoid various factors that may aggravate the condition;

(4) Encourage patients to do physical exercise;

(5) Encourage patients to adjust their mindset, arrange their work and rest time, and engage in entertainment and travel in moderation.

2. Give symptomatic treatment with medication

(1) Hyperventilation patients can be counseled to use abdominal breathing relaxation therapy;

(2) Patients with more obvious anxiety symptoms can choose various tranquilizers, tricyclic antidepressants such as doxepin and Prozac;

(3) Patients with severe insomnia may use midazolam or zopiclone as appropriate; menopausal women may use estrogen replacement therapy for a short period of time;

(4) For patients with symptoms of increased heart rate or hyperdynamic circulatory state, beta-blockers can be given.

We should have a positive attitude when treating cardiac neurosis. This article introduces the treatment methods for cardiac neurosis. These materials can help patients find out the causes of the disease in daily life and relieve the disease in time. Therefore, it is very important to control the disease. If you find any adverse symptoms in your daily life, you should seek medical attention in time and listen to the doctor's advice.