Cardiac Neurosis?

[beerhoch]

Hello,

I am a 38 yo white male with a family history of heart disease (Dad died of CAD at 42, maternal Grandmother had 1st heart attach at 52). I was diagnosed with CAD in June and had angioplasty & 4 stents (Cordis drug eluding type) for 2 blockages each in my LAD & RCA. I suffered a complication, my artery was perforated during the proceedure and a pericardial effussion started, leading to cardiac tamponade and a near death experience. An emergencey Pericardiocentisis followed along with days in the ICU with a drain in my chest, then several months of steroids to shrink the effussion. Follow up echoes show the effussion to be gome and no damage to my heart. I am now on Lipitor80 & Zetia10, and my ldl is down from 160 to 72. I'm also on Plavix, Enalapril, asprin and Atenolol (25mg x2). I have Gerd to add to all this.

I constantly feel chest, gastric pains & palpitaions and these lead to what I believe are panic attacks. I have had 2 thallium stress tests at 2 different facilities in the last 6 weeks, both of which were negetive. My cardiologist assures my that I am fine, I do not have a new blockage or restenosis. He believes that I am suffering from anxiety problems, which I am now forced to agree with. I believe that I am sufferuring from a panic disorder (cardiac neurosis?); I take my pulse and check my BP constantly and I panic at every discomfort I feel in my chest. It is becomming a problem for me.

Do you come across this sort of thing very often? What treatments or therapies do you recommend for your patients who suffer from similiar problem?

[Erik36]

Thanks for the kind words of wisdom.

Erik

[hankstar]

"Cardiac Neurosis" I guess this forum would have very few vistors if it wasn't for this "cardiac neurosis". Yes and it feeds off anxiety, but the fact remains "cardiac neurosis" is a label given to many who have a real disruption have the nervous system, usually some form of dysautonomia or PSVT for which there is no other explanation for their symptoms and leaves both patients and doctors baffled.

  In the past few years a much better understanding of this has evolved, for example a majority of panic attacks blamed on anxiety, about 50-60 % of these cases , PSVT was actually the trigger and not anxiety, after ablation about 85% of all panic attacks/disorder disappeared.

  While no doubt they are many that have no true heart problems and are true "cardiac neurotics", just to label everyone that has anxiety because of symptoms related to the heart a "cardiac neurotic" is unjustified because the heart symptoms are usually found to be the manifestation of some other medical condition that has not been diagnosed properly.

[suki1724]

Let's see, I had an ablation six weeks ago for pvc's, (20,000+ per 24hours verified by CCF), I was very symptomatic, and my wonderful, well-respected EP DR. at CCF told me that my symptoms were CAUSED BY MY PVC's.  The fact is that some people don't feel them, (lucky devils), some people can ignore them, and some people actually feel sick from them.  I am living proof of this.  Now that they're gone, I'm not having any shortness of breath, light-headedness or nausea.  Could it be possible that I had a REAL problem that was fixed?????  

[hankstar]

Look, I am not referring directly to you or your comments, I am writing my personal opinion on the subject regarding cardiac neurosis in general, I am not ashamed to admit that I would fall into the category of being a cardiac neurotic myself, in fact an EP cardiologist affiliated with CCF in Florida back in 1987 once labelled me a " cardiac cripple" despite the complete lack of evidence of heart disease after a stress test and holter monitor for severe symptomatic palpitations and anxiety caused by them.

Needless to say I was offended by label because I went about my everyday life despite the symptoms and was able to function normally and able to do alot more than others that had no symptoms at all. It was the words "cardiac cripple " that offended me , if he had labelled it as neurosis I would have not been offended at all.

  Please read my comments carefully as i have already received a warning from medhelp to ban me from posting on the forum if any more more flaming was to erupt because of my comments. I only started posting again because I personally never once initiated an attack on this forum so I felt I had nothing to stop posting for.

   I admire the way you and Erik set aside your differences the other day and acted like gentlemen, I hope it can be seem for us,not that we had differences to start with. You appear to be too much of an intelligent person to become involved in such childish and inconsiderate exhanges.

   I agree with Dr MJM reply completely also.

Have a nice day.

[Marilyn (runner)]

Hi,  In my non-expert opinion - the only thing that is important is 'what' you think as a cardiac patient and not what anyone else thinks..  

As a cardiac patient myself I personally would not let any cardiologist or PCP diagnose my symptoms as anxiety...  and if they were telling me it was anxiety - I would politely ask if THEY were an expert in this field of medicine.   IF not, then I would get a referral to seek the expert opinion of a psychiatrist with an MD Degree - as I think they would be the best expert to know the symptoms of 'anxiety' and they should be able to treat your anxiety or panic attacks - if indeed thats what it is.. and if it is - then your getting the proper care from an expert.  You may actually be experiencing "both" cardiac issues and psychiatric issues.  Heart disease in my opinion is 50% mental and 50% physical and some of these cardiac meds are playing havoc on some cardiac patients..  Which could be a case of just adjusting your meds.    

Good Luck
Marilyn (runner)

[pms_barbie]

ok what about those of us that have other problems along with the pvcs?  I have moderate to severe mitral valve prolapse with mild to moderate leakage.  I am suppose to get an echo every 6  months.  If I am neurotic sorry I cant help it.  I mean I hear that I may never need a valve replacement I just take that as dont worry about it right now but come back every six months because the eneviatable is just around the corner. They say my pvcs are benign because my heart hasnt stretched out yet...what happens when it does?  They become more than just benign then?