Cardioneurosis: what it is, symptoms, and how it differs from heart disease

The heart pounds, there is a pulling sensation in the chest, and examination after examination shows that the heart is fine. This discrepancy between sensations and results is familiar to many people, and it has a name — cardioneurosis. Below is a calm breakdown of what this condition is, how it manifests, and where the boundary lies between anxiety and heart disease.

What cardioneurosis is

Cardioneurosis is one of the names for panic disorder, or episodic paroxysmal anxiety. It is also called "VSD with crisis course" and "NCD (neurocirculatory dystonia)". This refers to recurrent attacks of acute anxiety with bodily sensations that are not tied to a specific situation and are therefore unpredictable. It usually begins at a young age; according to study results, about 1.7% of the adult population of the United States had its symptoms, and women — 2—3 times more often.

Why it occurs: the role of stress and anxiety

There is usually no single obvious cause. The likelihood is higher in people with another anxiety disorder, in those who have experienced stressful or traumatic events, including violence and bullying, with a long-term illness with pain, and with a history of alcohol or drug abuse.

An attempt to consciously control the condition during an attack only makes the symptoms more intense, and the anticipation of a new attack is often more tormenting than the attack itself.

Symptoms of cardioneurosis

During an attack, the following occur:

• rapid heartbeat and chest pain;
• difficulty breathing, muscle spasms;
• dizziness, nausea;
• a feeling of unreality of what is happening (derealization) and detachment from the body (depersonalization).

An attack usually lasts about 10 minutes, can be short — 1—5 minutes — and longer, up to 30 minutes, and anxiety may persist for about an hour. Generalized anxiety disorder is distinguished separately — another condition that often coexists with panic disorder.

How cardioneurosis differs from heart disease

Palpitations are the sensation that the heart is beating, pounding, or skipping beats; the rhythm may be either normal or disturbed. At rest, the heart usually contracts 60—100 times per minute: more than 100 — tachycardia, less than 60 — bradycardia, and an premature contraction is called an extrasystole. In most cases, palpitations are not dangerous, but sensations reflecting a rhythm disturbance may be more serious — especially with known heart disease, significant risk factors, valve abnormality, or low potassium.

Discomfort in the chest by itself does not indicate its source. Palpitations are caused by anxiety, stress, panic, fear, caffeine, stimulants, cold remedies, exertion, heat, nicotine, alcohol — and at the same time by heart disease, valve defect, low potassium, certain medications, increased thyroid activity, low blood oxygen levels. Therefore, panic disorder is distinguished from cardiovascular diseases, endocrine and metabolic disorders, epilepsy, bronchial asthma, CNS tumors, and the effects of medications or drugs.

How the diagnosis is made

The doctor asks about the nature of the sensations: missed or stopped beats, slow or fast rhythm, racing, thuds, fluttering, regularity, suddenness of onset and termination, connection with body position, emotions, intake of caffeine, alcohol, stimulants. An electrocardiogram may be performed, and if a rhythm disturbance is found — 24-hour monitoring, an echocardiogram, an electrophysiological study.

Generalized anxiety disorder is diagnosed when anxiety persists most of the time for at least 6 months, affects daily life, and is poorly controlled. Panic disorder requires recurrent severe attacks for at least a month, with anticipatory anxiety about the next one and anxiety-free intervals.

When to see a doctor urgently

Cardioneurosis by itself is not a reason to call an ambulance. You should call 103 or 112 in case of loss of consciousness, chest pain, shortness of breath, unusual sweating, or severe dizziness.

If palpitations have appeared for the first time in your life, you should see a doctor. You should see a doctor immediately, not postponing, if palpitations are new or have changed, if the pulse is above 100 per minute without exertion, anxiety, or heat, if extra beats are often felt — more than 6 per minute or in groups of three or more, and also with known heart disease or risk factors such as high cholesterol, diabetes, or high blood pressure.

The text is for reference: it helps to navigate sensations and formulate questions for the doctor, but does not replace a consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer