bubble_chart Overview

It is a special type of neurasthenia Guanneng, clinically characterized primarily by dysfunction of the cardiovascular system, and may also include other symptoms of neurasthenia Guanneng.

bubble_chart Diagnosis

(1) Medical history and symptoms: More common in young and middle-aged women, presenting with a variety of cardiovascular symptoms that vary in severity but are generally not serious. There is usually no evidence of organic heart disease, though it may coexist with organic heart disease or occur on its basis. The medical history should include detailed inquiries about potential triggers such as anxiety, emotional agitation, psychological trauma, or excessive fatigue, whether the patient has ever been diagnosed with "heart disease," the relationship between symptoms like flusteredness, shortness of breath, or chest discomfort and activity, exertion, or mood, as well as sleep status. Previous cardiac examination results, medication history, and treatment efficacy can aid in diagnosis.

(2) Physical examination findings: Physical examination often reveals no specific abnormalities. Patients may exhibit an anxious state or tense expression, with blood pressure either normal or grade I elevated. Cardiac auscultation may reveal increased heart rate, intensified heart sounds, and possibly a grade I-II soft systolic murmur in the precordial region, with occasional premature beats.

(3) Auxiliary examinations: Electrocardiograms often show sinus tachycardia. Some patients may exhibit ST-segment depression or horizontal depression, flattened, biphasic, or inverted T waves, mostly in leads II, III, aVF, or V4-6, with frequent changes. The propranolol test is positive. Some patients may test positive on exercise tests, but ST segments and T waves normalize during the "propranolol exercise test." Cardiac ultrasound can rule out structural abnormalities in the heart, major blood vessels, or valves.

(4) Differential diagnosis: The diagnosis of cardiac neurosis Guanneng should be made cautiously after excluding organic heart disease. Endocrine disorders such as hyperthyroidism, pheochromocytoma, and organic heart diseases like coronary artery disease, cardiomyopathy, or viral myocarditis should be ruled out. In coronary artery disease, chest discomfort is often related to activity or physical exertion, with a negative propranolol test and positive exercise test. Cardiomyopathy patients show positive findings on cardiac ultrasound. Viral myocarditis patients often have a history of upper respiratory infections, and elevated cardiac enzymes during the acute phase can aid in differentiation.

bubble_chart Treatment Measures

First, both doctors and patients should correctly understand that cardiac neuro Guanneng disorder is a functional disease. It is essential to establish a trusting doctor-patient relationship, jointly analyze the causative factors in detail, and conduct necessary examinations such as electrocardiograms, cardiac ultrasounds, and propranolol tests when needed. The doctor should carefully explain the condition to the patient to alleviate unnecessary concerns. Generally, bed rest is not required; instead, patients should maintain a regular lifestyle, eliminate unhealthy habits, and engage in appropriate physical activity. Medications to relieve symptoms include small doses of sedatives, such as diazepam, which can help reduce daytime symptoms when taken in the morning. Beta-blockers are effective for patients with a faster heart rate. Propranolol (10mg, 3–4 times daily) or metoprolol (12.5–25mg, twice daily) can also be used. After achieving therapeutic effects, treatment should be maintained for 2–3 months before gradually tapering off the medication to prevent symptom recurrence.