Neurosis and panic attack

Most people know firsthand what pain in the heart is. However, the heart can hurt in different ways, and its causes are different. Systemic diseases of the circulatory system do not necessarily cause heart pain. It also happens that the examination does not reveal any heart pathologies, but the feeling of discomfort continues to painfully remind itself.

If this is the case, then most likely we are talking about cardiac disorders associated with the nervous system. In medicine, this condition is known as cardiac neurosis.

What is cardiac neurosis

The nervous system works autonomously from all other parts of the body. At the same time, it is interconnected with all organs and systems. The brain and spinal cord make up the central nervous system, which is the regulator of all vital functions, reflex processes, and conscious actions. The nerve processes extending from it penetrate all parts of the body, entangling each part of it with a kind of sensitive network.

The nervous system directly reacts to the state of the psycho-emotional sphere, to the stress, shock, and changes in emotions experienced by a person. All negative factors related to mental state are reflected in the work of peripheral nerves, and ultimately, internal organs. Their work may be disrupted “due to nervousness.” It’s not for nothing that people say that all diseases are caused by nerves. Scientifically this is called neurosis.

Depending on the location of the neurosis, it can be gastric, intestinal, etc. We will look at one of the most common consequences of nervous stress - cardiac neurosis, or cardioneurosis.

Neuroses and heart rhythm disorders

Psychogenic heart rhythm disorders

States of painful, painful fear of death are inevitably accompanied by various heart rhythm disorders (regardless of whether they develop psychogenically or against the background of structural changes in the myocardium and the conduction system of the heart). Any violation of the usual, optimal heart rhythm for a given individual inevitably causes the patient to fear death, aggravating the severity of the arrhythmia and preventing its relief. Thus, a paroxysm of supraventricular tachycardia that has developed in a patient at home or at work is sometimes not relieved by intravenous infusion of 10-15 ml of a 10% solution of novocainamide, but stops as soon as the patient feels safe (during transportation in an ambulance or upon admission to hospital emergency room). A similar mechanism underlies arrhythmias and cardialgia that occur in patients in a hospital in the evening or on Sundays and holidays (i.e., in the absence of the attending physician).

Palpitation in neuroses

Complaints of palpitations not only with physical effort and the slightest excitement, but also at rest (in accordance with the daily fluctuations in well-being that many patients have and with an influx of thoughts of anxious and depressive content) is one of the almost indispensable components of hypochondriacal disorders in the clinic of neurotic and pseudoneurotic states. Particularly characteristic are attacks of palpitations in the morning (at the moment of awakening), when falling asleep and often at night (due to insomnia or superficial, intermittent and anxious sleep), as well as (“cold sweat”) with any surprise and “fright”. Extremely painful and painful psychogenic sinus (and sometimes even paroxysmal) tachycardia (with fear of death, pronounced hypochondriacal coloring and increased heart rate up to 140-160 per minute) can be caused in these patients by the mere mention of angina or myocardial infarction. Paroxysms of sinus and supraventricular (much less often - ventricular) tachycardia are considered as possible somatic manifestations and equivalents of the depressive phase of cyclothymia.

At the same time, in almost half of the patients, the sensation of heartbeats is not accompanied by any objective changes in the ECG and pulse, which is explained by the pathological perception and pathological interpretation of normal cardiovascular activity. Even more indicative in this regard is bradycardia, which often occurs at the height of passion (fear, horror, anger) and is perceived by patients as a heartbeat. Such conditions with absolute or relative bradycardia for a given patient and complaints of rapid heartbeat are not so rare in medical practice and are usually extremely skeptically regarded by therapists as completely incompatible phenomena. Doctors who are prone to gross overdiagnosis of organic heart disease in the presence of attacks of sinus or, especially, paroxysmal tachycardia, suspect patients of aggravation or set behavior when there is a clear discrepancy between the complaints and the objective findings of the pulse wave and heart rate on the ECG.

Even a purely subjective sensation of a rapid and intense heartbeat (not objectively confirmed by either a hard and tense pulse or tachycardia) turns out, however, to be unusually painful for the patient. Attacks of paroxysmal tachycardia are, without a doubt, one of the most striking and dramatic somatic manifestations of anxious depression at the height of an affective hypochondriacal explosion. Patients often claim that they hear the beat of their heart through a pillow or mattress and that this heartbeat even “makes the bed shake”; A number of patients experience an “unpleasant to the point of nausea” sensation of frightening “abnormal” pulsation in the temples, under the left shoulder blade, in the epigastric region, and sometimes throughout the body. Cardialgia and attacks of paroxysmal tachycardia are accompanied in some cases by sensations of chills, a rush of blood to the head and neck or heat throughout the body, the inability to take a full breath and lack of air (up to the fear of death from suffocation), taking on the character of a full-blown sympathetic-adrenal crisis.

Extrasystole with neuroses, arrhythmias

Particular diagnostic difficulties are presented, however, by heterotopic dysfunctions of automaticity (migration of the pacemaker, dissociation with interference, development of junctional rhythm or jumping contractions), as well as premature contractions of the entire heart or its parts. Psychogenic extrasystoles - more often ventricular (single, multiple or in the form of allorhythmia), less often atrial (and sometimes alternating ventricular or atrioventricular with atrial) - are usually noted along with the phenomena of cardiac erethism at the beginning of the depressive phase and disappear at its end. Patients, however, attribute so much importance to these sensations and spend so much emotion on them that they remember and talk only about the heart and depression can be completely masked.

In most cases, extrasystole occurs predominantly or only in the morning (in accordance with daily affective fluctuations), upon awakening or on the way to work and stops with emotional upsurge and a “change of scenery,” on weekends or during vacation, as well as while taking small (50-75 mg per day) doses of amitriptyline. And since it is precisely a certain periodicity, episodicity of somatic sensations that serves as the main condition for the formation and fixation of painful sensations in the precordial region, a sudden change in heart rate during extrasystole, sensations of interruptions and freezing, unexpected shocks in the chest cavity (at the moment of the extrasystole itself), short-term cardiac arrest often with slight dizziness (during a compensatory pause) and sharp beats in the chest with a rush of blood to the head (as a result of stronger contraction of the ventricles after a compensatory pause) really cause extreme anxiety in these patients.

Frequent disorders of automaticity and conduction (including sinoauricular or incomplete atrioventricular block, as well as unstable blockade of one of the branches of the His bundle), clearly identified during electrocardiographic examination, make it extremely difficult to timely recognize neurotic and pseudoneurotic conditions even for experienced cardiologists who, however, do not have adequate experience in diagnosing hypochondriacal raptus. Some of these patients are repeatedly hospitalized in cardiology (and even intensive care) departments due to paroxysms of atrial (occasionally atrioventricular and in isolated cases ventricular) tachycardia or tachyarrhythmic form of atrial fibrillation, which arise initially at the height of an anxious-hypochondriacal state, and later at the mere thought of death and illness.

Extracardiac, unstable paroxysmal disorders of heart rhythm and conduction develop, as a rule, at a certain depth of depression (mainly in its initial stages), disappearing when the latter increases to the degree of anaesthesia dolorosa or normalization of the patient’s affective status. The lability of the patient's affective state causes relapses of such disorders.

Absence of any structural pathological processes in the myocardium and signs of cardiac decompensation; transient (in accordance with fluctuations in the patient’s affective status) nature of arrhythmias and conduction disorders without progressive organic changes; the well-known stereotypicality of attacks that occur in a cliché manner in certain affectogenic (associated with the fear of death from heart damage) situations, and, finally, the undoubted therapeutic effect of tranquilizers and antidepressants indicate the functional, psychogenic origin of these paroxysms. Underestimation of psychogenic factors in the development of functional disorders of heart rhythm and conduction leads to inadequate treatment of such conditions, and the insufficient effectiveness of the usual arsenal of antiarrhythmic drugs only further convinces the patient of the severity and incurability of his suffering and becomes the reason for sometimes not at all harmless diagnostic studies (in particular, angiocardiography ).

Ed. F. Komarova

“Arrhythmia, palpitations in neurosis” - section Neurotic conditions

Panchakarma (from 7 to 21 days) www.ayur-veda.guru

Causes of cardiac neurosis

Heart neurosis is not a congenital, but an acquired condition. It can develop for a number of reasons. All of them, one way or another, are associated with an emotional state.

Everyone is familiar with the situation when, as soon as you get excited, your heart may “grab” or ache under your shoulder blade. The main reason for this disease is overstrain of the parasympathetic parts of the nervous system. Why does this happen?

Cardiac neurosis can be caused by external and internal causes. External ones include:

• hormonal imbalances;
• the period of life in which the body experiences hormonal changes;
• some chronic diseases of the nervous or endocrine system;
• chronic colds, ARVI;
• vegetative-vascular dystonia, which affects nerves and hormones;
• Unhealthy Lifestyle;
• harmful working conditions;
• polluted environment, environmental problems;
• lack of nutrients and microelements in the body.

All of these factors lower immunity, reduce performance, and cause a depressed emotional state of a person.
But there are also internal risk factors for cardioneurosis:

• emotional personality (for this reason it is observed more often in women than in men);
• tendency to asthenia - physiological weakness, fatigue, etc.;
• prolonged or frequent stress;
• sleep disorders;
• experienced psychological trauma;
• unresolved internal problems of a psychological nature;
• conflicts in the family or at work, with neighbors or other social environments;
• suspiciousness, suggestibility, a tendency towards negativity, pessimism, despondency and other character traits that lead to worries.

Symptoms of cardioneurosis

Heart pain and increased anxiety are two main signs of cardiac neurosis. Depending on their psycho-emotional state, patients describe the nature of unpleasant sensations in the heart area differently. This may appear as:

• aching pain;
• feeling of fullness;
• feelings of “freezing” or “squeezing” of the heart;
• pain in the muscles in the heart area, radiating to the shoulder blade, spine, neck;
• burning on the left under the ribs and sternum.

Typically, discomfort in the cardiac region is accompanied by other characteristic symptoms. Among them, vegetative manifestations are observed:

• shortness of breath (frequent shallow breathing, during which it is difficult to breathe deeply);
• dizziness;
• trembling of limbs;
• stiffness in movements;
• muscle spasms;
• headache;
• “throwing” into sweat, increased sweating;
• in addition to the sensation of heat, there may be an equally sharp sensation of cold;
• tachycardia (increased heartbeat), not due to fear or physical exertion;
• Short-term attacks of suffocation and a feeling of lack of air are possible.

In addition, the symptoms are complemented by panic thoughts, increased irritability, depressive mood, and pessimism. All these are signs of neurotic anxiety. This state differs from natural fears, doubts, and pragmatic behavior. Normal anxiety, fears, and the desire to play it safe are a normal way of human survival, helping him adapt to the conditions of existence. But with the neurotic nature of anxiety, it turns into panic. Its apogee is often the fear of death, cardiac arrest.

It is especially important to note the health impact of panic attacks. Fear and panic are extremely harmful to the body. They will not help you heal, but will only increase stress, which is already the cause of cardioneurosis. It gets to the point where a person convinces himself that he has a dangerous heart disease, although in fact this is not true. The patient begins to get nervous, fearing his own condition, and thereby exacerbating attacks of neurosis.

Signs and treatment of cardiac neurosis

The main cause of the development of heart neurosis (cardioneurosis) is stress. The process of the onset of the disease is simple: stress provokes a sharp release of adrenaline, which harms the heart and blood vessels. People of all ages are at risk for developing this disease.

There is no prevention of cardioneurosis. To reduce the likelihood of the disease occurring, it is necessary to avoid stressful conditions and periodically take sedatives. Especially if you have heart defects and heart diseases, such as myocarditis, rheumatic carditis and others. Also at risk are people who often suffer from acute respiratory infections and sore throats, are subject to frequent mood swings, depression, smokers and drink alcohol, and have had pneumonia. Let's look at the signs and treatment of heart neurosis.

Signs of cardiac neurosis.

A person suffering from cardioneurosis often experiences such signs of the disease as attacks of dizziness, insomnia, pain in the heart, shortness of breath, tachycardia (accelerated pulse) and arrhythmia. During physical exertion and nervous tension, I experience discomfort in the heart area and dark vision. A strong sound is enough - and the patient is covered in perspiration, his heart is tormented, and he may even faint in severe cases. Patients with cardiac neurosis are very excitable.

Despite all the external signs of abnormal heart function, medical tests such as echography and ECG do not reveal heart disease. Therefore, it is very difficult for a doctor to make a diagnosis, because all tests are normal, but the patient feels unwell, he may find signs of hypertension, ischemia and other heart diseases.

How can you identify heart neurosis?

The disease heart neurosis can easily be mistaken for another disease of the cardiovascular system, for example, ischemia or angina. Therefore, you need to pay attention to the following signs of the disease.

If your heart hurts, and validol does not help in any way and nitroglycerin causes your heart rate to increase, try taking Valocordin or Corvalol. If you feel better after taking medications, be sure to consult a neurologist, because this may be a sign that you have heart neurosis. There is another sign of the disease, but it is not so obvious - this is the frequency of pain in the heart. The pain either subsides or returns again, and this lasts for hours.

Is it worth seeing a doctor and treating cardioneurosis?

By all indications, your heart is working normally, but think about it: from time to time, attacks of tachycardia and arrhythmia occur, and this leads to heart destruction. And if the disease is not treated, then after some time of such abnormal work, you may develop coronary heart disease. This is a serious disease. Of course, with good rest, heart neurosis can go away on its own, without any treatment. But often this does not happen, because the main cause of the disease is neurosis, which practically does not go away on its own. And after some time, all the signs of cardioneurosis will return again - heart pain and dizziness will appear again.

How to deal with heart neurosis?

This disease should be treated by two specialists - a cardiologist (general practitioner) and a neurologist (psychotherapist, neuropsychiatrist). The therapist will help you cope with signs of heart neurosis, such as shortness of breath, dizziness and pain. The neurologist, in turn, will treat the cause of the disease - depression and neurosis.

Medicines for the treatment of cardiac neurosis are completely different, these include sedatives - Corvalol, Valoserdin, and sedatives, for example, novopassit or glycine. Antihypertensive drugs and beta-blockers are also used. But remember, all medications for the treatment of cardioneurosis should be prescribed by a specialist so as not to harm the body.

Do not self-medicate - only a doctor and no one else can prescribe antidepressants and tranquilizers, because these drugs seriously affect the functioning of the nervous system. You can buy and take only herbal preparations yourself, such as Negrustin and Persen.

Also, take your medications correctly. We dilute such a well-known medicine as Corvalol with water and then drink it. But few people know that this causes essential oils to lose their effectiveness. That is why the drug must be dropped into a spoon, drunk, and then washed down with water. Then the rate of absorption of the drug will increase, and, accordingly, the effectiveness will increase. You can also drop the medicine onto a piece of sugar and dissolve it by placing it under your tongue. The dosage of the drug can be selected as follows: the number of drops is equal to the number of years. But you should not drink more than 50 drops at a time.

Medical nutrition.

Of course, treatment of heart neurosis with drugs is effective, but it is worth introducing various healthy foods into your diet. They must be rich:

- vitamin B6, there is a lot of it in potatoes, meat products, legumes, yeast, beer, cod liver;

- magnesium, found in lentils, sunflower and pumpkin seeds, nuts, various greens, whey and bran bread. It is also recommended to take vitamin complexes Magne B6 and Magvit B6.

Diagnostics

The main principle for diagnosing cardiac neurosis is its differentiation from functional cardiac pathologies. Often the nature of pain in the heart during neurosis is very similar to pain during serious diseases, for example, angina pectoris. And increased or weakened heartbeat resembles signs of arrhythmia, which occurs with dangerous heart ailments.

In order to exclude the presence of systemic disorders of the cardiovascular system in the patient, it is necessary to consult a cardiologist. In addition, the local physician will refer the patient for a consultation with a neurologist.

To make a correct diagnosis, you need to monitor your blood pressure level, undergo an ECG examination, and ultrasound of the heart. In some cases, it is necessary to undergo an extended examination - bicycle ergometry, as well as Holter ECG monitoring. The last method is a comparison of the results of heart function throughout the day.

Only on the basis of all the data obtained can the doctor determine the type of disease and prescribe the correct treatment.

Treatment

Treatment of cardiac neurosis most often does not require potent medications. Most often, the effect that comes from using traditional medicine is sufficient for recovery.

But the most important therapeutic component is peace of mind, peace, lack of stress, and lifestyle adjustments. Therefore, in addition to a cardiologist and a neurologist, a psychotherapist is often involved in the treatment of such patients.

However, one should not take the manifestations of cardioneurosis lightly. Without treatment, the disorder can lead to more serious illnesses.

Drug treatment

To relieve stress, it is recommended to take several Glycine tablets, placing them under the tongue.

Also effective for calming:

• infusion or tablets with valerian root extract;
• Novo-Passit;
• Valocordin;
• Corvalol.

For long-term therapy, motherwort tincture is suitable. The doctor may prescribe medications to normalize blood pressure, relieve headaches, and panic attacks.

In more severe cases, tranquilizers, sleeping pills, and antidepressants can be used to treat neurosis. However, creating a calm environment is paramount in therapy. Otherwise, the medications will only provide a temporary effect. The psychological state of the patient is of utmost importance in treatment and prevention.

Folk remedies

If a person has an attack of cardiac neurosis, you need to unfasten the tight fasteners in the chest area and ensure a flow of fresh air. It’s good to go outside, open a window or window, and let in the fresh wind. The patient should try to calm his breathing, try to inhale the air deeper, and exhale more slowly. It will feel better in a few minutes.

Traditional medicine offers many ways to relieve nervous tension with the help of herbs. It is good to drink soothing teas that have a beneficial effect on the cardiovascular system.

Herbs that are useful for cardioneurosis:

• Motherwort cordial;
• Melissa or mint;
• Adonis spring;
• Hop cones;
• Valerian root.

These herbs can be brewed together or separately, 2-4 tablespoons per 1 liter of boiling water. You can drink half a glass at any time of the day, preparing the infusion for 1-2 days at once. It is especially good to take such a calming drink shortly before going to bed.

Massage, a change of scenery, and rest will help you get rid of heart neurosis. After all, heart pain and autonomic disorders are often a manifestation of excessive mental or physical stress received by a person at work.

Symptoms of tachycardia in neurosis

Deviation is accompanied by external and internal manifestations. Signs of pathology occur when a person experiences conflict, stress, or expects bad or good news.

Painful sensations in the heart can last for several days or even a month. They have varying degrees of severity:

1. With cardialgia, a person is bothered by dull, pressing or sharp pain in the chest area. They can spread to other parts of the body, for example, the arm, shoulder blade, neck. These manifestations are accompanied by anxiety and fear of death. If you undergo an electrocardiogram, you may not notice any symptoms. But sometimes neurogenic cardialgia leads to spasm of the coronary arteries, which can cause circulatory problems.
2. Panic attacks are observed, during which strong impulses of fear roll in, and hot and cold flashes disturb. There is a feeling of hiding and running away. The heart rate increases to critical levels.
3. An increase in heart rate always accompanies panic attacks. It can also occur for other reasons: during severe physical exertion or as a result of early awakening. Tachycardia can become permanent.
4. Patients report a feeling of heart sinking. This is how extrasystoles appear that occur in the morning. The heart may freeze for seconds, and after that the heartbeat returns to normal. If you change the situation or calm down, the symptom disappears.
5. A feeling of shortness of breath, fever or chills indicate an incorrect reaction of the body to neurosis.

People suffering from neuroses are often diagnosed with vegetative-vascular dystonia, which occurs when the functions of the nervous system are impaired. Manifestations of rapid heartbeat can also be noticed after eating food. This is due to the rush of blood to the gastrointestinal tract.

These conditions also include a feeling of dizziness, trembling, swelling or paleness of the skin.

In hypertension, the presence of cardiac neurosis is accompanied by increased blood pressure, pain in the heart and headaches.

WE RECOMMEND: Distinctive signs of sinoauricular block

In such situations, treatment difficulties arise, since each patient complains of a large number of different symptoms.

It is important to be able to distinguish heart pain associated with neurosis from angina pectoris. If there are problems with the main muscle, any physical activity causes attacks of pain. You can improve your well-being only with the help of Nitroglycerin.

With neurosis, heart medications do not bring relief, so patients usually ask the doctor to prescribe something more effective.