What kind of disease does cardiac neurosis belong to?

Cardiac neurosis is a special type of neurosis. The main clinical manifestation is dysfunction of the cardiovascular system, and may be accompanied by other symptoms of neurosis. Diagnosis (1) History and symptoms: It is more common in young and middle-aged women. Symptoms of the cardiovascular system are diverse, sometimes mild and sometimes severe but mostly not serious. Generally, there is no evidence of structural heart disease, but it can be associated with organic heart disease. exist at the same time or occur on the basis of the latter. The medical history should be asked in detail whether there are any triggers such as anxiety, agitation, mental trauma or overwork, whether you have ever been diagnosed with "heart disease", the relationship between palpitation, shortness of breath or precordial discomfort and other feelings and activities, fatigue and mood, sleep What's the situation? Previous cardiac test results, medication history and efficacy can help in diagnosis. (2) Physical examination findings: There are often no special findings in physical examination. They often show anxious or nervous expressions, and their blood pressure may be normal or slightly elevated. During cardiac auscultation, the heart rate may increase, heart sounds may increase, and there may be soft systolic murmurs of grade I-II in the precordial area, and premature beats may occur occasionally. (3) Auxiliary examination ECG often shows sinus tachycardia, some patients have ST segment depression or horizontal downward shift, T wave is flat, biphasic or inverted, mostly in leads II, III, aVF or V4-6 Appears, changes frequently, and tests positive for propranolol. Some patients had a positive exercise test, but the ST segment and T wave returned to normal during the "propranolol exercise test". Cardiac ultrasound can rule out structural abnormalities of the heart, great vessels, and valves. (4) Differential diagnosis: The diagnosis of cardiac neurosis needs to be made on the basis of excluding organic heart disease, and caution should be used 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, and the propranolol test is negative and the exercise test is positive; patients with cardiomyopathy have positive findings in cardiac ultrasound examination; patients with viral myocarditis often have a history of influenza, and serum cardiac enzymes are elevated in the acute phase. Available for identification. Diseases that are easily misdiagnosed 1. Angina pectoris: Most patients with coronary heart disease and angina pectoris are middle-aged and elderly men. Most of them have risk factors for coronary heart disease, such as high blood pressure, hypercholesterolemia, diabetes, and smoking history. Angina pectoris often occurs during physical activity, exercise or emotional excitement. The location of pain is relatively fixed, mostly behind the sternum. The duration generally does not exceed 3 to 5 minutes. Taking nitroglycerin by mouth can relieve the pain. If it is difficult to identify based on symptoms alone, exercise electrocardiography, radionuclide myocardial imaging, and coronary angiography can be performed if necessary. 2. Hyperthyroidism: Typical symptoms include thyroid enlargement, murmur of blood vessels in the neck, fine trembling of hands, exophthalmos, fear of heat and weight loss, etc. The identification is not difficult. It is difficult to distinguish atypical manifestations from cardiac neurosis, and the diagnosis can be made by measuring serum T3 and T4. 3. Myocarditis: There is usually a clear history of infection (virus or bacteria) 1 to 2 weeks before the onset of illness. Typical manifestations include heart enlargement, weakened heart sounds, galloping rhythm, prolonged P-R interval on the electrocardiogram, and various types of arrhythmias. Atypical or mild cases are more difficult to identify. Pathogenic tests, such as serum virus neutralizing antibody titers, have auxiliary diagnostic value. 4. Mitral valve prolapse syndrome: Mitral valve prolapse can have many symptoms that are similar to cardiac neurosis, and a small number of patients who were diagnosed with cardiac neurosis in the past were misdiagnosed as mitral valve prolapse. . Systolic clicks and systolic murmurs can often be heard in mitral valve prolapse with careful auscultation, and echocardiography can often make a definite diagnosis. 5. Pheochromocytoma: Generally there are characteristic signs or laboratory test indicators, and the identification is not difficult. (5) Clinical treatment: First of all, doctors and patients must correctly understand that cardiac neurosis is a functional disease, establish a mutually trusting doctor-patient relationship, and jointly analyze the factors causing the disease in detail. If necessary, perform electrocardiogram, cardiac ultrasound, Propranolol test and other examinations, carefully explain the condition to the patient, so that the patient can relieve unnecessary worries. Generally, there is no need to rest in bed. You should live a regular life, eliminate bad living habits, and participate in appropriate physical activities. Medications to reduce symptoms include low-dose sedatives such as diazepam, which can be taken in the morning to reduce symptoms during the day. Beta blockers are effective for those with a fast heart rate. Propranolol 10 mg, 3-4 times/d, or Betaloc 12.5-25 mg 2 times/d can also be used. Treatment should be maintained for 2-3 months after efficacy is achieved. Then gradually stop taking the above medicine, otherwise symptoms are likely to recur. Treatment principles 1. Psychological treatment is the main approach for this disease: ① Let the patient understand the nature of the disease to relieve his concerns and make him believe that there is no organic cardiovascular disease; ② Medical staff must be patient with the patient in order to gain his Trust and cooperation; ③ Avoid various factors that cause the condition to worsen; ④ Encourage patients to engage in physical exercise; ⑤ Encourage patients to adjust their mentality, arrange their work and rest time, and engage in appropriate entertainment and travel. 2. Provide symptomatic treatment with drugs: ① Patients with hyperventilation can be counseled to use abdominal breathing relaxation therapy; ② Patients with obvious anxiety symptoms can use various stabilizing preparations, such as tricyclic antidepressants doxepin, Prozac, etc. ; ③ Patients with severe insomnia should use midazolam or zopiclone as appropriate; menopausal women can use estrogen replacement therapy in a short period; ④ For those with symptoms of accelerated heart rate or hyperdynamic circulation state, β-blockers can be given. (6) Preventive measures: Eliminate triggers, such as worry, tension, and annoyance; correct insomnia; avoid the effects of overwork and noisy environmental factors.

Once you suffer from cardiac neurosis, you don’t need to be too nervous, let alone bed rest. You can take the following measures: 1. Regularly participate in physical activities within your ability, such as Tai Chi, etc., to exercise and enhance your physical fitness; 2. Live a regular life, Arrange your life reasonably and try to balance work and rest; 3. Avoid excessive stress and do not engage in work that lasts for too long and requires high concentration; 4. People with severe insomnia can choose diazepam, chlordiazepoxide, Jiannao mixture, oryzanol, A variety of vitamins, propranolol, etc., or Chinese patent medicines such as Guipi Decoction, Zhusha Anshen Pills, Huanglian Ejiao Decoction, and Jiaotai Pills can be used to achieve good therapeutic effects. (7) Prognosis Most cardiac neurosis is not an organic disease of the heart. As long as active treatment is given, the patient can generally recover and the prognosis is good. However, patients with severe long-term symptoms can significantly affect their normal life and work.