Brief introduction of disease, onset age, disease classification, clinical manifestations, pathological analysis, etiology, pathophysiology, diagnosis an
Brief introduction of disease, onset age, disease classification, clinical manifestations, pathological analysis, etiology, pathophysiology, diagnosis and examination, treatment scheme, health tips, scientific nursing and disease introduction. Cardiovascular neurosis is a clinical syndrome characterized by symptoms related to cardiovascular diseases and belongs to a type of functional neurosis. This disease is a special disease, and its symptoms are manifested in cardiovascular and respiratory systems, but the examination results show that everything is normal. Obviously, the patient feels very uncomfortable, but he just can't find the disease. Although most doctors think that since there is nothing wrong with the body, they don't have to pay attention to it, but patients will feel very uncomfortable, and sometimes they will feel depressed, which will seriously affect their study and work. This disease is also called neurasthenia and anxiety neurosis. The onset age mostly occurs in young people, especially in 20~50 years old; There are more women than men, especially menopausal women. There is no evidence of organic heart disease in clinic, and the prognosis is good, but patients with severe long-term symptoms can obviously affect their normal life and work. Cardiovascular neurosis is a clinical syndrome characterized by symptoms related to cardiovascular diseases, and it is a type of neurosis. Most of them occur in youth and prime of life, especially those aged 20-40. The etiology is not clear, which may be related to nerve type, environmental factors, personality and heredity. Classification of diseases The clinical manifestations of cardiovascular medicine are varied and subjective, lacking the internal relationship between objective evidence and symptoms. Usually, the following symptoms of cardiovascular diseases are the main symptoms, which may be accompanied by other neurosis symptoms, such as insomnia, dreaminess, impatience, irritability, upset, loss of appetite, dizziness, tinnitus and so on. Cardiovascular neurosis 1. Palpitation: Consciously rapid heartbeat, feeling flustered, and tension or fatigue are often aggravated. Second, breathing difficulties: chest tightness, poor breathing, often feel that the air is not enough to open the window, and even require oxygen. Many patients often take deep breaths or sigh-like breathing actions to relieve symptoms, leading to hyperventilation, respiratory alkalosis and aggravating symptoms. Third, precordial pain: the pain site is not fixed, and the pain attack has nothing to do with labor activities, mostly at rest; The nature of pain is often described as needle-like or drag-like; Duration varies, generally longer; Eating nitroglycerin can't relieve the pain, but it will take dozens of minutes. Fourth, the symptoms of autonomic nervous dysfunction, such as hyperhidrosis, cold hands and feet, shaking hands, frequent urination, increased stool frequency or constipation. Contrary to more symptoms, physical examination lacks positive signs with important pathological significance. It can be found that the heart rate is increased, the heart sounds are enhanced, there may be short systolic murmurs or premature beats, blood pressure is slightly increased, and leg reflexes are more active. The x-ray examination of the heart is normal. Electrocardiogram can show sinus tachycardia, sinus arrhythmia, atrial or ventricular premature beats and nonspecific ST-T wave changes. The etiology of pathological analysis is unclear, which may be related to nerve type, environmental factors and personality. The neurological types of patients are often depression, anxiety and sadness. When mentally stimulated by the external environment, or when the work is tense and stressful, it may lead to illness. Some patients lack knowledge of heart disease and are overly anxious about suspected symptoms, which leads to this disease. Patients with organic heart disease may also be accompanied by cardiovascular neurosis. In the course of the disease, nervous system and endocrine system dysfunction, sympathetic hyperfunction, sympathetic and parasympathetic dysfunction often occur. When intravenous infusion of isoproterenol, the heart rate of patients is often faster and more obvious than that of ordinary people. Sometimes it can be accompanied by high dynamic circulation, such as increased arterial pulsation and increased left ventricular ejection velocity; Abnormal reactions to exercise, psychological tests or pain stimuli may also occur. Books about cardiovascular neurosis are all about the autonomic nervous system, which is controlled and regulated by the cerebral cortex nerves. Under normal circumstances, the excitement and tension of the cerebral cortex alternate and coordinate. The brain is the main body of human emotions and thinking. When the external emotional stimulus is too strong or lasts too long, some areas of the cerebral cortex are too excited and have abnormal coordination function, which leads to vasospasm and slow blood circulation in the brain, which in turn leads to insufficient blood supply to the brain, hypoxia of brain cells and deposition of metabolic wastes, thus reducing the neuroregulatory ability of the brain. Because the cerebral cortex plays a leading role in the autonomic nervous system, the disorder of the brain, the headquarters of the human body, often leads to the dysfunction of the autonomic nervous system. The root cause of autonomic nerve dysfunction is: 1, subcortical capillary spasm or capillary stenosis due to arteriosclerosis, hyperlipidemia, blood viscosity and other reasons, which leads to insufficient blood supply to the cerebral cortex, so the cerebral cortex lacks oxygen and nutrition, the command of the cerebral cortex is out of control, and the lower center and peripheral autonomic nerves act independently. So all parts of the body have physiological symptoms. 2. The center of autonomic nerve is the limbic system of the brain, which plays a central command role under the direct control of the cerebral cortex. Once the limbic system of the brain suffers from hypoxia or other injuries, the will and instructions of the cerebral cortex cannot be transmitted correctly, leading to autonomic nerve dysfunction. 3. Insufficient secretion of neurotransmitters between autonomic nerves and between autonomic nerves and peripheral effectors weakens or disappears the function of nerve transmitting information, which is also an important reason for autonomic nerve dysfunction. This transmitter is 5- hydroxytryptamine (5-HT) and norepinephrine, so a series of 5- hydroxytryptamine reuptake inhibitors have appeared in western medicine, such as Prozac and Celeste. The psychosomatic view of this disease is 1. Psychosomatic medicine is an important part of the emerging medical science system and a special field of medicine, which studies medical problems related to body and mind. Psychosomatic medicine in a narrow sense refers to the study of the etiology, pathology, clinical manifestations, diagnosis, treatment and prevention of psychosomatic diseases (including psychophysiological disorders). Psychosomatic medicine in a broad sense is a discipline that studies all psychosomatic phenomena in the struggle between human beings and diseases and expounds the role of psychological factors in the occurrence, development and prognosis of diseases, involving many disciplines such as medicine, biology, psychology, education, sociology and anthropology. People not only have biological bodies, but also thoughts, feelings and desires, which are closely related to the environment. Therefore, psychosomatic medicine integrates them into a whole concept. Cardiovascular neurosis related books II. Psychosomatic diseases: Psychosomatic diseases are mainly physical symptoms, and the pathogenic factors are closely related to emotional disorders and personality factors. Psychosomatic diseases, also known as psychophysiological disorders, are a group of physical diseases related to psychosocial stimulation. They have definite organic lesions (such as coronary atherosclerosis) or definite pathophysiological processes (such as migraine), and psychosocial factors are of great significance in the occurrence, development, diagnosis and treatment of diseases. Psychosomatic diseases are the result of the interaction of many factors, and the influence of psychosocial factors and the importance of genetic and biological factors can not be ignored, so we must treat them with the concept of psychosomatic integration. Psychosomatic diseases can be divided into narrow sense and broad sense. Generally speaking, psychosomatic diseases in a narrow sense are a group of physical diseases, but psychosocial factors are of great significance in their diagnosis and treatment. In addition, psychosomatic diseases in a broad sense also include: although physical diseases are caused by biology, psychosocial factors are of relatively important significance in their diagnosis; Mental diseases caused by psychological factors (such as some neurosis) are mainly manifested as physical symptoms, that is, psychosomatic diseases are a group of diseases that are between physical diseases and mental diseases and overlap with each other. Psychosomatic diseases in a broad sense are all diseases studied from the viewpoint of biological-psychological-social medical model. It is believed that psychology and body are two aspects in the same life process, so psychological factors must have different connections with various diseases and play a certain role in each pathological process. There are disorders of nervous and endocrine system, especially autonomic nervous system, such as increased sympathetic nerve tension, and the heart rate of patients increases faster than that of ordinary people when intravenous infusion of isoprenaline. Sometimes it can be accompanied by high dynamic circulation, such as increased arterial pulsation, increased left ventricular ejection velocity and shortened circulation time. Abnormal reactions to exercise, psychological tests and pain stimuli may also occur. Some patients are caused by lack of knowledge of heart disease and excessive anxiety about the disease or their suspected symptoms. The etiology of the disease is still unclear, which may be related to nerve type, environmental factors and personality. Most western medicine can't detect it because western medicine can only detect organic lesions. The neurological types of patients are often depression, anxiety and sadness. When mentally stimulated by the external environment, or when the work is tense and stressful, it may lead to illness. Some patients lack knowledge of heart disease and are overly anxious about suspected symptoms, which leads to this disease. Patients with organic heart disease may also be accompanied by cardiovascular neurosis. In the course of the disease, nervous system and endocrine system dysfunction, sympathetic hyperfunction, sympathetic and parasympathetic dysfunction often occur. When intravenous infusion of isoproterenol, the heart rate of patients is often faster and more obvious than that of ordinary people. Sometimes it can be accompanied by high dynamic circulation, such as increased arterial pulsation and increased left ventricular ejection velocity; Abnormal reactions to exercise, psychological tests or pain stimuli may also occur. In the pathophysiological process of cardiovascular neurosis, there are disorders of nervous and endocrine system, especially autonomic nervous system, such as increased sympathetic nerve tension, and the heart rate of patients increases faster than that of ordinary people when intravenous infusion of isoprenaline; Sometimes it can be accompanied by high dynamic circulation, such as increased arterial pulsation, increased left ventricular ejection velocity and shortened circulation time. Abnormal reactions to exercise, psychological tests and pain stimuli may also occur. Some patients are caused by lack of knowledge of heart disease and excessive anxiety about the disease or their suspected symptoms. Diagnostic examination 1. Diagnosis and differential diagnosis According to the characteristics of the cardiovascular system, such as many symptoms, few signs, no specificity, and no relevant evidence of heart disease, the diagnosis of cardiovascular neurosis can usually be made. Attention must be paid to excluding organic heart disease; Also be careful not to misdiagnose the disease as organic heart disease and give unnecessary examination and treatment; At the same time, it should be noted that organic heart disease may be accompanied by cardiovascular neurosis, which may confuse the judgment of the degree of heart disease. Second, this disease is mainly differentiated from the following diseases 1. Angina Pectoris Cardiovascular Neurosis Patients with angina pectoris caused by coronary heart disease are generally older, mostly male, and have predisposing factors for coronary heart disease. Angina pectoris mainly occurs in the process of exercise or emotional excitement, and the pain site is relatively fixed, lasting less than 15 minutes, and nitroglycerin can often be relieved. Sometimes it is difficult to distinguish the pain in the new anterior region from angina pectoris. Exercise electrocardiogram, 20 1 thallium myocardial imaging and coronary angiography can be performed when necessary. 2. Hyperthyroidism is characterized by goiter, vascular murmur, shaking hands, exophthalmos and emaciation. Diagnosis can usually be made by measuring serum T3 and T4. 3. Myocarditis Myocarditis patients often have chest tightness, tachycardia and ST-T wave changes in electrocardiogram, which is not easy to distinguish from this disease. However, myocarditis usually has a clear history of infection (virus or bacteria) before the onset, and its typical manifestations are enlargement of the heart, weakening of heart sounds, galloping of the heart rhythm, prolongation of PR interval of electrocardiogram, decline of heart function, enlargement of ventricle by echocardiography and so on. 4. Others such as mitral valve prolapse syndrome and pheochromocytoma are usually not difficult to distinguish according to the characteristics of these diseases. Third, the prognosis of this disease does not affect people's life span, but serious people can't live and work normally for a long time. Fourth, patients with similar symptoms of heart disease often think that they have heart disease or lung disease after the onset, and they are worried about telling their doctors that their heartbeat is irregular, their heart is beating badly, or they have difficulty breathing. These symptoms are more obvious when you are quiet, but you can't feel them when you are busy and exercising. Symptoms can be summarized as follows: 1. Palpitation: the patient feels that his heart is beating abnormally, and his heartbeat is more intense and flustered. Sometimes he felt his heart suddenly jump, followed by a brief palpitation. During the examination, it was found that the heart beat too fast and the apex beat strongly. 2. Difficulty in breathing: Patients always feel that the inhaled air is not enough, or feel stuffy in the chest, and need to take a deep breath or breathe like a long sigh. With the increase of breathing depth and frequency, it is easy to hyperventilate for a long time and cause respiratory alkalosis, such as dizziness, numbness of limbs and convulsions. 3. Pain in the precordial region: the apical region and the left hypogalactia region often have tingling or knife-like pain, sometimes chest tightness and dull pain. The pain time can be long or short, sometimes only a few seconds, sometimes as long as several hours. This kind of pain has nothing to do with physical activity. Most of it occurs in quiet time, and sometimes it can last for several days or longer after intense work and emotional excitement. 4. Symptoms of autonomic nervous dysfunction: hyperhidrosis, cold hands and feet, shaking hands, flatulence in the upper abdomen, abdominal pain, frequent urination, increased stool frequency or constipation. 5. Other symptoms: fatigue, insomnia, poor sleep or dreaminess, low fever, loss of appetite, dizziness, headache, muscle pain, etc. Treatment plan Treatment measures include: (1) making patients understand the nature of the disease to relieve their worries; (2) Medical staff and their families try to find possible inducing factors and remove them as much as possible; (3) Encourage patients to take physical exercise; (4) Psychological consultation to eliminate ideological obstacles; (5) Drug therapy, such as using sedatives, beta blockers and antidepressants if necessary. The disease is mainly treated with drugs, supplemented by psychotherapy. First of all, we should listen to the medical history patiently, learn as much as possible about the possible causes and related factors, carry out careful physical examination and necessary laboratory examination, and then choose Lily Qingnao Shen Jing Decoction for treatment, explain the nature of the disease in simple terms, and use some suggestive language to help patients relieve their worries. Encouraging patients to adjust their mentality, arrange their work and rest time, and carry out entertainment, tourism and sports activities in moderation are very helpful for the rehabilitation of diseases. Health tips 1. The disease is common in young and middle-aged women, especially menopausal women, and it is a clinical syndrome characterized by symptoms related to cardiovascular diseases. It may be related to nerve type, environmental factors and personality, and belongs to a kind of functional neurosis. 2. The chest pain associated with this disease is mostly short-term (a few seconds) tingling or persistent (a few hours) dull pain; Patients often like to take a deep breath or sigh from time to time; The location of chest pain is mostly near the apex of the left breast or often changes; Symptoms often appear after fatigue, not when fatigue occurs; Nitroglycerin is invalid or "effective" for more than 10 minutes; Often accompanied by palpitations, fatigue and other neurasthenia symptoms. Scientific nursing 1. First of all, let the patient know that the disease is not a real heart disease, and reducing concerns will help relieve symptoms. 2. Try to improve the living and working environment of patients and avoid factors that are easy to aggravate the condition, such as nervousness and sadness. 3, do more physical exercise, exercise can make you happy and healthy, and these can effectively relieve symptoms; 4, all kinds of methods can not alleviate the condition, or when the symptoms are serious, you can use some drugs, such as sedatives. The influence of fatigue on cardiovascular neurosis Overwork, whether it is brain fatigue after mental work or physical fatigue after physical activity, may aggravate the condition of patients with cardiovascular neurosis. Excessive mental work, continuous excitation of cranial nerves, sympathetic nerve excitation and vagus nerve inhibition at the same time, leading to palpitations, chest tightness, dyspnea, insomnia, hyperhidrosis and so on. , thus aggravating the condition. Traditional Chinese medicine believes that God governs the mind, and the normal physiological function of God makes him refreshed, conscious, quick-thinking, and sensitive to external information. If the mind governs the gods, there will be abnormal mental thinking, which will lead to insomnia, dreaminess, uneasiness and even delirium. Excessive physical labor can reduce human immunity, disease resistance and metabolism, and the stress response is unbalanced. In this case, patients with cardiovascular neurosis can easily induce aggravation. Chinese medicine believes that physical fatigue can first hurt human vitality, and then sad, resulting in deficiency of both heart and spleen.