Heart Anxiety Neurosis (Cardiophobia)

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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

Symptoms

  • 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]

Diagnosis

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.

12 Responses to Heart Anxiety Neurosis (Cardiophobia)

  1. Pamela Gleason says:

    One more thing added with the sharp pain in both arm shooting down thought my hand and fingers (vaines and tendants being carved alive) my arms feel heavy as well

  2. Pamela Gleason says:

    Why am I having sharp pains from both elbows down throughout my hands an fingertips. It feels like my vaines and tendants are being carved with a knife (being carved alive)

  3. Rachel Oseth says:

    Trusting in God.
    The ONLY cure after two years of anxiety of the most frightening and morbid kind was christian radio. Not a church- goer nor active in any one religion, believe me when i say this was quite the surprise. Any time i started any sort of anxiety attack, or simply felt anxious, tuning into a local christian radio station eliminated ALL anxiety.
    no joke.
    Good luck.. I understand how frightening they can be.
    Food helped as well, although not 100 % effective, unlike the christian music.

  4. EDDIE BOY JUANINO says:

    HOW TO PREVENT MY ANXIETY PLS HELP ME ANY TIPS

    • Jan Modric says:

      Eddie, you may want to find someone you trust and speak with him or her in person.

    • Amit says:

      Exercise man trust me take it slow but exercise it’s the key

    • frank says:

      “St-John’s worth” tincture, helps me a lot.

    • Rachel says:

      Trusting in God.
      The ONLY cure after two years of anxiety of the most frightening and morbid kind was christian radio. Not a church- goer nor active in any one religion, believe me when i say this was quite the surprise. Any time i started any sort of anxiety attack, or simply felt anxious, tuning into a local christian radio station eliminated ALL anxiety.
      no joke.
      Good luck.. I understand how frightening they can be.
      Food helped as well, although not 100 % effective, unlike the christian music.

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