Cardiac neurosis or cardiac phobia is a fairly common condition. Sufferers suffer from heart discomfort, but it is not due to an organic disease of the heart.
What is cardiac neurosis?
Cardiac neuroses usually have psychosomatic causes and occur over a long period of time. Statistics say that in about one in three patients with heart complaints, no organic causes are found and the complaints are due to cardiac neurosis. In the case of cardiac phobia, those affected often complain of heart complaints over a long period of time. A cardiac neurosis is accompanied by a great fear of the affected person of a serious heart disease, up to a heart attack. However, no sufficient organic causes can be found for the symptoms that occur. A cardiac neurosis is therefore a psychosomatic disorder, which is more precisely defined as a somatoform autonomic dysfunction. Cardiac neuroses occur very frequently. About one third of the patients with heart complaints cannot be traced back to physical causes and thus fall into the area of cardiac neuroses. Mainly men between the ages of 40 and 60 are affected by cardiac neurosis.
Causes
Cardiac neurosis (cardiac phobia) usually cannot be attributed to organic causes. As a rule, the heart complaints arise from unconscious fears of the patients. A cardiac neurosis is usually a psychological defense mechanism. The actual fears are transferred to another target, the heart. In this way, the affected person is distracted from his or her actual fears. Stressful and anxiety-provoking events can be the loss of a close person or the fear of losing one’s job. Often there are people with heart disease in the social environment of patients with cardiac neurosis, so that the affected person unconsciously projects his fears onto the heart. In some cases, cardiac neurosis can also develop when a diagnosis that is actually harmless is misunderstood and classified by the affected person as serious and severe. Other mental illnesses, such as anxiety disorders or depression, can also trigger cardiac neurosis.
Symptoms, complaints, and signs
The main symptom of cardiac neurosis is a constant fear of having a heart attack. This fear can manifest itself in panic attacks and even a fear of death. During the panic attacks, there is an increased pulse and a rise in blood pressure. Most often, symptoms such as palpitations, heart palpitations and pain in the heart region also occur during panic attacks. Sweating, shortness of breath, trembling and dizziness are also common. Often the symptoms alternate. In addition, those affected often suffer from nervous gastrointestinal complaints and sleep disturbances. As a rule, no organic causes are found during examinations, but the quality of life is nevertheless severely limited by the anxiety. Sufferers live internally under constant tension because they constantly fear that they have a heart problem and that something bad will happen to them. To prevent this, they put themselves in a protective posture and constantly watch themselves, which exacerbates the problem because it is a psychological problem. Because they often feel misunderstood by those around them, sufferers often withdraw and develop the belief that no one can help them. However, the social withdrawal is and the resulting loneliness again reinforces the excessive introspection and anxiety.
Diagnosis and course
To diagnose cardiac neurosis with certainty, all possible organic causes must be excluded. For this purpose, in addition to a general physical examination, cardiac examinations are necessary. These include ECG and exercise ECG, as well as echocardiography (ultrasound examination of the heart). In addition, blood pressure is measured and a blood test is performed. Often, an x-ray examination is also performed. Often, cardiac neurosis is diagnosed only after numerous visits to the doctor. If cardiac neurosis is diagnosed and treated early, the patient’s condition usually improves after one to two years. If other mental illnesses are present, the treatment period can be significantly longer. Untreated cardiac neurosis can become chronic.
Complications
Cardiac neurosis can cause both psychological and physical symptoms that can limit the patient’s daily life and quality of life. In most cases, severe anxiety and panic attacks occur. Sufferers also suffer from depression and other moods and therefore no longer take an active part in life. The patient’s ability to cope with stress also decreases enormously and there is pain in the heart and chest. Not infrequently, the pain is also accompanied by breathing difficulties and hyperventilation. Sufferers experience an oppressive feeling in the chest and are afraid of death. It is not uncommon for sufferers to also lose consciousness due to cardiac neurosis, which can cause them to injure themselves in a fall. In the worst case, the disease can lead to the death of the patient if it is treated too late or not at all. There are no further complications during the treatment itself. However, they can prove to be serious if they are mainly psychological in nature. If treatment is successful, the patient’s life expectancy is not affected by cardiac neurosis.
When should one go to the doctor?
When symptoms such as chest and heart pain, shortness of breath, and trepidation are noticed, in some cases a full-blown cardiac neurosis is present. A visit to the doctor is indicated if the symptoms occur quite suddenly and do not subside on their own. Slowly increasing symptoms should also be clarified by a doctor. If hyperventilation, heart pain or chest pain occur, the patient should consult a doctor immediately. The same applies to dizziness and panic attacks. People suffering from depression or anxiety disorders are particularly susceptible to developing cardiac neurosis. The same applies to people with psychological problems who have heart patients in their circle of acquaintances, because these groups of people are at increased risk of unconsciously projecting their fears onto the heart. In the best case, the causative mental illness is treated before cardiac neurosis develops. If symptoms have already developed, the family physician must be consulted. This person can establish contact with a psychologist and also refer the affected person to a cardiologist. The physician or therapist must be informed immediately of any new symptoms or complaints.
Treatment and therapy
In the treatment of cardiac neurosis, the most important thing is a gentle and sensitive approach by the physician. It must be made clear to the patient that there are no organic causes and that the complaints are harmless. At the same time, the patient must be made to feel that he or she is being taken seriously. Under no circumstances must it be conveyed that the complaints are due to imagination or fantasy. In fact, this is not the case, because symptoms such as palpitations are actually present. Cardiac neurosis can be treated by psychotherapy. In many cases, medication is also used. Beta blockers, antidepressants or benzodiapines can be prescribed. Beta blockers can be used to treat symptoms such as palpitations, even if the cardiac symptoms cannot be traced to a direct disease of the heart. Antidepressants and benzodiapines are used when additional mental illnesses such as anxiety disorders or depression are present. Autogenic training and exercise can also be helpful. These measures are particularly recommended if sufferers have developed avoidance behavior. In this way, they learn that moderate exercise and stress on their own bodies is not harmful or dangerous in cardiac neurosis.
Outlook and prognosis
The prognosis is positive for cardiac neurosis only if the sufferer recognizes it as a psychological problem. Therefore, the terms cardiac phobia and cardiac neurosis already include the psychological aspect. However, it is problematic that the symptoms of cardiac neurosis seem to be clinical and physical. There are palpitations, heart palpitations, sweating, panic attacks and similar symptoms in certain situations. These can be very frightening. They often lead the sufferer from one doctor to another. Often, the heart’s discomfort can be confirmed, but a cause cannot be found. Because sufferers usually describe only physical symptoms, cardiac neurosis is often not immediately recognized as an anxiety disorder. Initially, all differential diagnostic means are exhausted in the medical establishment. After all, there could also be an organic cause.Cardiac neurosis belongs to the panic disorders. It can be misjudged for a very long time because of its frightening symptoms. In addition, there are often long waiting times for psychotherapeutic care. The earlier therapy begins, the better the prospects for recovery. Without long-term treatment, cardiac neurosis usually cannot be successfully managed. It is important that the affected person can develop trust in his body again. The prognosis is worse if the patient has an anxious underlying attitude or can be classified as suicidal because of the cardiac phobia.
Prevention
Cardiac neurosis cannot be prevented. However, improvement of symptoms can be achieved more quickly if the possibility of psychosomatic causes is considered as soon as possible after the onset of the first cardiac symptoms. Those affected should also trust the diagnosis of the attending physician and be aware that the complaints are actually harmless and have no organic causes. In this way, the symptoms of cardiac neurosis can be treated more quickly and successfully.
Follow-up
In most cases, the person affected by cardiac neurosis has very few options or measures of aftercare available to him. With this disease, the affected person must first and foremost see a doctor as soon as possible so that there are no further complications or complaints. The sooner a physician is contacted, the better the further course of the disease. Therefore, early diagnosis is highly recommended and the affected person should see a medical professional at the first symptoms or signs of the disease. In most cases, cardiac neurosis is treated by taking various medications. The patient should always ensure that the medication is taken regularly and in the correct dosage. In the event of interactions or side effects, a doctor should always be consulted first so that no further complications arise. Likewise, psychological treatment should be carried out in the case of cardiac neurosis. The help and support of one’s own family is also very important and also necessary in order to prevent further depression or other psychological upsets. In most cases, cardiac neurosis does not result in a reduced life expectancy of the affected person.
Here’s what you can do yourself
With cardiac neurosis, confidence in one’s physical ability is lost. Effort is avoided in order to spare the heart, and stamina and muscle strength suffer as a result. Regular exercise and light sports activities help to break this vicious circle: Walks are a good way to start, but as your confidence grows, endurance sports such as cycling, jogging or swimming have a positive effect on the cardiovascular system. Training should be started very carefully and increased only slowly. A trusted training partner provides security in case heart problems occur during the activity. Cardiac phobia is often associated with constant mental tension, which is manifested on a physical level by muscle tension. These, in turn, can trigger stabbing pains in the chest. Various relaxation techniques help to loosen the muscles and restore mental balance. In the case of cardiac neurosis, yoga, special breathing exercises and progressive muscle relaxation in particular prove to be effective. If excessive demands or unresolved problems are hiding behind the cardiac phobia, learning stress management techniques can help to cope better with the challenges of everyday life. If self-treatment does not lead to improvement, the help of a behavioral therapist should be sought. This can also help if, against one’s better judgment, one does not succeed in perceiving occasional changes in the heartbeat as normal and harmless.
