Heart Anxiety Neurosis (Cardiophobia)

Published: October 5, 2016
Last reviewed: May 17, 2017

What is heart anxiety neurosis?

Heart anxiety neurosis is a combination of symptoms, such as chest pain and difficulty breathing, that resembles a heart disease in a person with no detectable organic heart abnormality [2]. Also called cardiophobia, it is considered a psychosomatic disorder, that is a physical manifestation of an anxiety disorder.



Synonyms [2,4]:

  • Cardiac neurosis
  • Cardiophobia
  • Da Costa’s syndrome
  • Soldier’s heart
  • Postwar syndrome
  • Chronic asthenia
  • Neurocirculatory asthenia
  • Effort syndrome
  • Functional cardiovascular disease
  • Irritable heart syndrome
  • Somatoform autonomic dysfunction


  • Recurring central or left chest pain that can be strong enough to mimic heart attack; the pain is often associated with fear of dying
  • Heart stings – sudden, sharp pains on the left side of the chest
  • Burning or tingling in the chest that can radiate to the neck and down the left arm
  • Palpitations (pounding heart) or feeling of skipped or extra beats
  • Rapid heart rate (tachycardia) triggered by stooping or reclining
  • Rapid breathing (hyperventilation)
  • Fatigue, shortness of breath, dizziness and excessive sweating after moderate exercise
  • Anxiety
  • Insomnia, headache, nausea, abdominal discomfort, diarrhea
  • References: [1,3]

Physical examination reveals no physical abnormalities.

Heart-related pain location

Picture 1. Pain in heart anxiety neurosis can resemble pain in a heart disease (angina pectoris).

Causes, Triggers and Risk Factors

  • Young males between 18 and 40 years of age are at greatest risk.
  • Prolonged continuous overexertion with lack of rest
  • Stressful event, such as loss of job, separation or death of a close person resulting in a post-traumatic stress disorder
  • Prolonged unsuccessful treatment of a chronic disease
  • Mitral valve prolapse
  • References: [1,4]


A doctor can make a diagnosis after a physical examination and eventual investigations, such as EKG.

Differential Diagnosis

Conditions with similar symptoms than heart anxiety neurosis:

  • Panic attack
  • Irregular heartbeat (arrhythmia)
  • Angina pectoris (chest pain lasting less than 5 minutes)
  • Heart attack (severe squeezing chest pain lasting over 15 minutes)
  • Pericarditis (chest pain aggravated by lying down, fever)
  • Costochondritis (pain aggravated by applying pressure on the ribs near the breastbone)
  • Trapped gas (constant pain in the upper abdomen)

Chart 1. Heart Anxiety vs Heart Disease

Heart Anxiety Angina Pectoris/Heart Attack
Who is at increased risk? Anyone 18-40 y/o Men >45, women >55 y/o with family history of heart disease
Main trigger Anxiety Physical effort
Pain relief by rest Not necessary Yes in angina; not in heart attack
Pain relief by drugs No Yes in angina; not in heart attack
EKG Usually normal Abnormal

Chart 1 references: [5]

Treatment and Prevention

The following can help in the treatment of heart anxiety [1]:

  • Avoiding unnecessary stress
  • Resolving triggering issues in relationships
  • Avoiding sudden postural changes, such as standing up quickly
  • Lying down when symptoms are severe
  • Regular physical exercise
  • Behavioral therapy

There is INSUFFICIENT EVIDENCE about the effectiveness of vitamins B and C and GABA in relieving heart anxiety.

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