Neurocirculatory asthenia

Neurocirculatory Asthenia (NCA), also known as cardiac neurosis, effort syndrome, and soldier's heart, is a condition characterized by a set of symptoms that include fatigue, palpitations, dyspnea (difficulty breathing), and dizziness. It is considered a type of functional cardiovascular disorder, meaning that it is a condition with symptoms that are noticeable and problematic but without an identifiable structural or organic cause. The term "neurocirculatory asthenia" reflects the belief that the condition involves both the nervous and circulatory systems.

Symptoms and Diagnosis

The primary symptoms of Neurocirculatory Asthenia include persistent fatigue, palpitations (feeling that the heart is racing or pounding), dyspnea, and dizziness. These symptoms often occur in the absence of any physical exertion and can be exacerbated by stress or emotional factors. Patients may also experience chest pain, a sensation of faintness, and anxiety, which can lead to a misdiagnosis of heart disease or anxiety disorders.

Diagnosis of NCA is primarily clinical, based on the patient's history and symptoms, as there are no specific laboratory tests or imaging studies that can definitively diagnose the condition. It is important for healthcare providers to rule out other potential causes of the symptoms, such as heart disease, thyroid disorders, or psychiatric conditions, before diagnosing a patient with neurocirculatory asthenia.

Etiology

The exact cause of Neurocirculatory Asthenia is unknown, but it is believed to involve a combination of psychological and physiological factors. Stress, anxiety, and emotional distress are thought to play a significant role in the development and exacerbation of symptoms. Some theories suggest that NCA may be related to dysregulation of the autonomic nervous system, which controls involuntary bodily functions, including heart rate and blood pressure.

Treatment

Treatment for neurocirculatory asthenia focuses on symptom management and addressing the underlying psychological factors. Lifestyle modifications, such as regular exercise, stress management techniques, and avoiding caffeine and alcohol, can help alleviate symptoms. Psychological therapies, including cognitive-behavioral therapy (CBT), can be effective in managing the anxiety and stress that often accompany NCA. In some cases, medications such as beta-blockers may be prescribed to help control palpitations and tremors.

Prognosis

The prognosis for individuals with neurocirculatory asthenia is generally good, especially with appropriate treatment and lifestyle modifications. While the condition can be chronic and symptoms may persist over time, most people are able to manage their symptoms effectively and maintain a normal quality of life.

Historical Perspective

The concept of neurocirculatory asthenia has evolved over time. It was first described during World War I as "soldier's heart," a condition observed in soldiers who exhibited symptoms of fatigue, palpitations, and shortness of breath without any apparent heart disease. Over the years, the understanding of NCA has shifted from a purely physical ailment to a condition that involves both psychological and physiological components.