What is heart anxiety neurosis?
Heart anxiety neurosis is a combination of symptoms, such as chest pain and difficulty breathing, that resembles a heart disease in a person with no detectable organic heart abnormality [2]. Also called cardiophobia, it is considered a psychosomatic disorder, that is a physical manifestation of an anxiety disorder.
Synonyms [2,4]:
- Cardiac neurosis
- Cardiophobia
- Da Costa’s syndrome
- Soldier’s heart
- Postwar syndrome
- Chronic asthenia
- Neurocirculatory asthenia
- Effort syndrome
- Functional cardiovascular disease
- Irritable heart syndrome
- Somatoform autonomic dysfunction
Symptoms
- Recurring central or left chest pain that can be strong enough to mimic heart attack; the pain is often associated with fear of dying
- Heart stings – sudden, sharp pains on the left side of the chest
- Burning or tingling in the chest that can radiate to the neck and down the left arm
- Palpitations (pounding heart) or feeling of skipped or extra beats
- Rapid heart rate (tachycardia) triggered by stooping or reclining
- Rapid breathing (hyperventilation)
- Fatigue, shortness of breath, dizziness and excessive sweating after moderate exercise
- Anxiety
- Insomnia, headache, nausea, abdominal discomfort, diarrhea
- References: [1,3]
Physical examination reveals no physical abnormalities.
Picture 1. Pain in heart anxiety neurosis can resemble pain in a heart disease (angina pectoris).
Causes, Triggers and Risk Factors
- Young males between 18 and 40 years of age are at greatest risk.
- Prolonged continuous overexertion with lack of rest
- Stressful event, such as loss of job, separation or death of a close person resulting in a post-traumatic stress disorder
- Prolonged unsuccessful treatment of a chronic disease
- Mitral valve prolapse
- References: [1,4]
Diagnosis
A doctor can make a diagnosis after a physical examination and eventual investigations, such as EKG.
Differential Diagnosis
Conditions with similar symptoms than heart anxiety neurosis:
- Panic attack
- Irregular heartbeat (arrhythmia)
- Angina pectoris (chest pain lasting less than 5 minutes)
- Heart attack (severe squeezing chest pain lasting over 15 minutes)
- Pericarditis (chest pain aggravated by lying down, fever)
- Costochondritis (pain aggravated by applying pressure on the ribs near the breastbone)
- Trapped gas (constant pain in the upper abdomen)
Chart 1. Heart Anxiety vs Heart Disease |
||
| Heart Anxiety | Angina Pectoris/Heart Attack | |
| Who is at increased risk? | Anyone 18-40 y/o | Men >45, women >55 y/o with family history of heart disease |
| Main trigger | Anxiety | Physical effort |
| Pain relief by rest | Not necessary | Yes in angina; not in heart attack |
| Pain relief by drugs | No | Yes in angina; not in heart attack |
| EKG | Usually normal | Abnormal |
Chart 1 references: [5]
Treatment and Prevention
The following can help in the treatment of heart anxiety [1]:
- Avoiding unnecessary stress
- Resolving triggering issues in relationships
- Avoiding sudden postural changes, such as standing up quickly
- Lying down when symptoms are severe
- Regular physical exercise
- Behavioral therapy
There is INSUFFICIENT EVIDENCE about the effectiveness of vitamins B and C and GABA in relieving heart anxiety.
- References
- Soumeya Meraghni, What is heart anxiety neurosis? PGD International
- Simson U et al, 2001, Cardiac neurosis PubMed
- Anxiety symptoms and causes Mayo Clinic
- Eifert GH, 19992, Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain PubMed
- Who is at risk for heart attack? National Heart, Lung and Blood Institute
One more thing added with the sharp pain in both arm shooting down thought my hand and fingers (vaines and tendants being carved alive) my arms feel heavy as well
Why am I having sharp pains from both elbows down throughout my hands an fingertips. It feels like my vaines and tendants are being carved with a knife (being carved alive)
Trusting in God.
The ONLY cure after two years of anxiety of the most frightening and morbid kind was christian radio. Not a church- goer nor active in any one religion, believe me when i say this was quite the surprise. Any time i started any sort of anxiety attack, or simply felt anxious, tuning into a local christian radio station eliminated ALL anxiety.
no joke.
Good luck.. I understand how frightening they can be.
Food helped as well, although not 100 % effective, unlike the christian music.
Your comment is much appreciated.
Thanks! ??
Thanks for your comment! It helped me too!
HOW TO PREVENT MY ANXIETY PLS HELP ME ANY TIPS
Eddie, you may want to find someone you trust and speak with him or her in person.
Exercise man trust me take it slow but exercise it’s the key
“St-John’s worth” tincture, helps me a lot.
Trusting in God.
The ONLY cure after two years of anxiety of the most frightening and morbid kind was christian radio. Not a church- goer nor active in any one religion, believe me when i say this was quite the surprise. Any time i started any sort of anxiety attack, or simply felt anxious, tuning into a local christian radio station eliminated ALL anxiety.
no joke.
Good luck.. I understand how frightening they can be.
Food helped as well, although not 100 % effective, unlike the christian music.
I doubted you, but you were right! Thanks!