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THE ELECTROCARDIOGRAM IN NEUROCIRCULATORY ASTHENIA (ANXIETY, NEUROSIS OR NEURASTHENIA): A STUDY OF 203 NEUROCIRCULATORY ASTHENIA PATIENTS AND 757 HEALTHY CONTROLS IN THE FRAMINGHAM STUDY

1958; American College of Physicians; Volume: 49; Issue: 6 Linguagem: Inglês

10.7326/0003-4819-49-6-1351

1539-3704

Kannel Wb, Thomas R. Dawber, Mandel E. Cohen,

Cardiac Imaging and Diagnostics

Article1 December 1958THE ELECTROCARDIOGRAM IN NEUROCIRCULATORY ASTHENIA (ANXIETY, NEUROSIS OR NEURASTHENIA): A STUDY OF 203 NEUROCIRCULATORY ASTHENIA PATIENTS AND 757 HEALTHY CONTROLS IN THE FRAMINGHAM STUDYWILLIAM B. KANNEL, M.D., T. R. DAWBER, M.D., F.A.C.P., MANDEL E. COHEN, M.D.WILLIAM B. KANNEL, M.D.Search for more papers by this author, T. R. DAWBER, M.D., F.A.C.P.Search for more papers by this author, MANDEL E. COHEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-49-6-1351 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA number of reports have suggested that neurocirculatory asthenia, sometimes called anxiety neurosis or neurasthenia,1 is a cause of or is associated with electrocardiographic abnormalities.2-9 The nature of these abnormalities was variable and in some instances resembled those found in organic heart disease. Such variations as transient S-T segment deviation3, 4 and T-wave flattening or inversion2 are among those considered to be due to neurocirculatory asthenia. Other reports do not support these claims.10, 14In view of the fact that an electrocardiogram is a common laboratory test used not only in cardiac patients but also as part of the complete...Bibliography1. CohenWhite MEPD: Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome), Psychosom. Med. 13: 335, 1951. CrossrefMedlineGoogle Scholar2. MendkosLogue MHRB: Unstable T-waves in leads II and III in persons with neurocirculatory asthenia, Am. Heart J. 31: 711, 1946. CrossrefMedlineGoogle Scholar3. Master AM: Effort syndrome or neurocirculatory asthenia in the Navy, U. S. Nav. M. Bull. 41: 666, 1943. Google Scholar4. GraybielWhite APD: Inversion of the T-wave in lead I or II of the electrocardiogram in young individuals with neurocirculatory asthenia, with thyrotoxicosis, in relation to certain infections, and following paroxysmal ventricular tachycardia, Am. Heart J. 10: 345, 1935. CrossrefGoogle Scholar5. Walker WJ: The patient with functional cardiovascular disorders (neurocirculatory asthenia), Am. Heart J. 42: 97, 1951. CrossrefGoogle Scholar6. Friedman M: Studies concerning the etiology and pathogenesis of neurocirculatory asthenia. III. The cardiovascular manifestations of neurocirculatory asthenia, Am. Heart J. 30: 478, 1945. CrossrefMedlineGoogle Scholar7. LogueHansonKnight RBJFWA: Electrocardiographic studies in neurocirculatory asthenia, Am. Heart J. 28: 574, 1944. CrossrefGoogle Scholar8. BattroLavalle Cobo AJ: Modificaciones electrocardiográficas observadas en la astenia neuro-circulatoria, Rev. argent. de cardiol. 3: 215, 1936. Google Scholar9. MagendantzShortsleeve HJ: Electrocardiographic abnormalities in patients exhibiting anxiety, Am. Heart J. 42: 849, 1951. CrossrefMedlineGoogle Scholar10. Cohen ME: Neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome, cardiac neurosis), M. Clin. North America 33: 1343-1364 (Sept.) 1949. CrossrefMedlineGoogle Scholar11. CohenWhiteJohnson MEPDRE: Neurocirculatory asthenia, anxiety neurosis or the effort syndrome, Arch. Int. Med. 81: 260, 1948. CrossrefGoogle Scholar12. Editorial: Neurocirculatory asthenia in soldiers, J. A. M. A. 115: 537, 1940. CrossrefGoogle Scholar13. Altschule MD, in Clinical progress in cardiovascular disease, 1952, Grune & Stratton, New York, p. 118. Google Scholar14. WhiteCohenChapman PDMEWP: The electrocardiogram in neurocirculatory asthenia, anxiety neurosis, or effort syndrome, Am. Heart J. 34: 390, 1947. CrossrefMedlineGoogle Scholar15. BurchWinsor GET: A primer of electrocardiography, 2nd Ed., 1949, Lea and Febiger, Philadelphia. Google Scholar16. DawberMeadorsMoore TRGFFE: Epidemiological approaches to heart disease: the Framingham study, Am. J. Pub. Health 41: 279, 1951. CrossrefGoogle Scholar17. DawberKannelLoveStreeper TRWBDERB: The electrocardiogram in heart disease detection: a comparison of the multiple and single lead procedures, Circulation 5: 559, 1952. CrossrefMedlineGoogle Scholar18. White PD: Heart disease, 4th Ed., 1951, The Macmillan Company, New York. Google Scholar19. OppenheimerLevineMorisonRothschildSt. LawrenceWilson BSSARAMAWFN: Report on neurocirculatory asthenia and its management, Mil. Surgeon 42: 409, 1918. Google Scholar20. WheelerWhiteReedCohen EOPDEWME: Neurocirculatory asthenia (anxiety neurosis, effort syndrome, neurasthenia): a twenty year follow-up study of 173 patients, J. A. M. A. 142: 878, 1950. CrossrefMedlineGoogle Scholar21. CohenBadalKilpatrickReedWhite MEDAEWPD: The high familial prevalence of neurocirculatory asthenia (anxiety neurosis, effort syndrome), Am. J. Human Genet. 3: 126, 1951. MedlineGoogle Scholar22. CohenConsolazioJohnson MEFRE: Blood lactate response during moderate exercise in neurocirculatory asthenia, anxiety neurosis or effort syndrome, J. Clin. Investigation 26: 339, 1947. CrossrefMedlineGoogle Scholar23. JonesMellersh MV: A comparison of the exercise response in various groups of neurotic patients, and a method of rapid determination of oxygen in expired air, using a catharometer, Psychosom. Med. 8: 192, 1946. CrossrefMedlineGoogle Scholar24. JonesScarisbrick MSR: A comparison of the respiration in patients with effort syndrome and in normal subjects, Proc. Roy. Soc. Med. 34: 549, 1941. Google Scholar25. CraigWhite HRPD: Etiology and symptoms of neurocirculatory asthenia: Analysis of 100 cases, with comments on prognosis and treatment, Arch. Int. Med. 53: 633, 1934. CrossrefGoogle Scholar26. CohenWhite MEPD: Studies of breathing, pulmonary ventilation and subjective awareness of shortness of breathing (dyspnea) in neurocirculatory asthenia, effort syndrome, anxiety neurosis, J. Clin. Investigation 26: 520, 1947. CrossrefMedlineGoogle Scholar27. Toro Villa G: Cardiac neurosis, Am. Heart J. 33: 700, 1947. Google Scholar28. WheelerWilliamsonCohen EOCRME: Heart scare, heart surveys, and iatrogenic heart disease: emotional and symptomalogical effects of suggesting to 162 adults that they might have heart disease, J. A. M. A. 167: 1096, 1958. CrossrefMedlineGoogle Scholar29. CohenWheelerThomson MEEOKJ: Unpublished data. Google Scholar30. WhiteJones PDTD: Heart disease and disorders in New England, Am. Heart J. 3: 302, 1928. CrossrefGoogle Scholar31. Wood P: DaCosta's syndrome (or effort syndrome), Brit. M. J. 1: 767, 805, 845, 1941. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication December 4, 1957.From the National Heart Institute, National Institutes of Health, Public Health Service, U. S. Department of Health, Education, and Welfare, The Cardiac Research Laboratory, Massachusetts General Hospital, and the Department of Medicine, Harvard Medical School.Requests for reprints should be addressed to William B. Kannel, M.D., Heart Disease Epidemiology Study, 123 Lincoln Street, Framingham, Massachusetts. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byVentricular Repolarization: Theory and Practice in Non-Ischemic MyocardiumVentricular Repolarization: Theory and Practice in Non-Ischemic MyocardiumLife events and neurocirculatory asthenia. A controlled studyAutonomic balance revisited: Panic anxiety and heart rate variabilityNeurocirculatory asthenia: a reassessment using modern psychosomatic criteriaFunktionelle Herz-Kreislauf-StörungenSystemic hormonal and physiological abnormalities in anxiety disordersDa Costa's syndrome or neurocirculatory asthenia.ReferencesA behavioral study of middle-aged chest pain patients: Physical symptom reporting, anxiety, and depressionElevated ejection fractions in patients with the anginal syndrome and normal coronary arteriogramsHyperventilation Syndrome: A Frequent Cause of Chest PainMyocardial function during atrial pacing in patients with angina pectoris and normal coronary arteriogramsThe fate of women with normal coronary arteriograms and chest pain resembling angina pectorisReferencesCHRONIC ANXIETY NEUROSIS: CLINICAL AND SEXUAL ASPECTSCardiovascular disease in African PygmiesStudies in Neurocirculatory Asthenia (Da Costa's Syndrome): I. Variations with Regard to Symptoms and some Pathophysiological SignsStudies in Neurocirculatory Asthenia (Da Costa's Syndrome): II. Statistical Analysis of the Associations between Symptoms and Signs in the Work Test and the Orthostatic Test, and the Correlation between these Factors and Immobilization and Bodily ConstituDie Coronarerkrankungen. Coronarinsuffizienz, Angina pectoris und Herzinfarkt 1 December 1958Volume 49, Issue 6Page: 1351-1360KeywordsAnxietyElectrocardiographyHeartHospital medicineHypertensionLaboratory testsMedical educationMedical servicesPrevention, policy, and public healthResearch laboratories ePublished: 1 December 2008 Issue Published: 1 December 1958 PDF downloadLoading ...