Creating Waves of Awareness
Cardiac Neurosis A Mental State Or Mental Disease?
Cardiac Neurosis or Cardiophobia as is widely known refers to symptoms arising due to persistent anxiety about contracting some cardiac disorder or not getting well once it is acquired. Many believe that it may be a precursor or the first stage in the spectrum of development of Hypertensive state or Ischemic heart disease. Paradoxically many Physicians instill fear amongst the patients about heart disease. I must admit and the readers would agree that the latter is widely practiced and is becoming a menace where as the former is the reflection of a sick state that can very well be managed and treated – both by sympathetic words and sweet pills.
A month ago, Ashok, aged 28 years, an apprentice at a printing press came to our clinic. He complained of episodes of sensation of a load on the anterior aspect of the chest since 2-3 weeks. It aggravated on rest. No history of increase of symptoms after meals or on exertion. It had started after his co-worker aged about 70 years suffered a myocardial infarct. Ashok had already been to a local physician who took his ECG (that was normal) and was generous enough to instill a fear in him that he is likely to get a heart attack. The poor man had no history of hypertension or diabetes in the past and could hardly speak English. But in a day or two was well acquainted with the words “Treadmill Test”, “Angiography”, “Atenolol 50mg”, etc. He started having disturbed sleep, dis-interest in tobacco (that he was addicted to), work and sex. Obviously when he came to us, after hearing his woes, he was counseled and responded to 3 doses of Argentinum Nitricum. He is still under follow-up. Today he is back to work without CARDIO-PHOBIA.
I also happened to see Mrs. Rekha, a 46 years old plump banker. She was advised urgent hospitalization in view of her accelerated (180/110mm Hg) & fluctuating blood pressure and an ECG that depicted – Left ventricular stain pattern. Since it was the year end (25th March 2008), she refused to get hospitalized but chose homoeopathy instead. On history we learnt that she was peri-menopausal, had frequent hot flushes (the doctor says there is tremendous heat in my body due to high blood pressure), missed her only son who was in Bangalore pursuing Hotel management and the work load at the bank. She was quite anxious and was sure that she would end up in the ICCU. A round of educating her about menopause, frequent telephonic talks with her son and few repetitions of Arsenic Alb settled her completely. Today she is fit as a fiddle. There are no BP fluctuations and although her menopause continues, there are no complaints. CARDIO-PHOBIA - good bye.
An interesting short study was carried out last month by the department of homoeopathic cardiology, The National Academy of Homoeopathy, India. We sent the following questionnaire to 38 Cardiologists, Allopathic Physicians, Psychiatrists, Homoeopaths, Ayurvedacharyas and Patients suffering from heart ailments. Sixty eight percent participants responded. Following were the questions along with their collective answers (text and graphs)
Ans – It is a term used to define collective symptoms and signs of anxiety relating to cardiovascular diseases described by an individual who experiences persistent stress and is unable to cope with it. It is a serious problem as cardiac disease itself and warrants treatment.
Ans – Generally Physicians from all the schools were of the opinion that the prevalence of functional heart diseases in the general population of Vidharbha was around 25%. Rest of the patients that presented to the clinics were having some form of structural heart disease.
Ans –54% agreed and said – Yes, It is a double edged sword. Where as 46% disagreed with the statement.
Ans – Only 20% agreed with the premise that ignorance about heart disease was really bliss in the earlier days. Of these 20% majority were from the patient group. The medical fraternity was quite united in remarking that ignorance was, is and would always be a bane. Cardiophobia is much better than ignorance.
5. Is the Media also responsible for flaring fear about Heart Diseases?
Ans – Many (23%) participants believed that media was just doing its work of educating the masses about heart diseases and their causations, etc. But those persons, who are cardiophobics, take the negative aspect of the campaign. Other participants (77%) opined that with so many channels (electronic / print) competing with each other, sometimes the views of experts are dissected in a wrong manner.
6. Do Physicians for their personal gains create a market of cardio-neurotics?
Ans: An over-whelming 66% voted in affirmative where-as the rest did not agree.
Another study was carried out by the Department of Homoeopathic Cardiology, The National Academy of Homoeopathy, India between 19/9/2006 to 19/5/2007.
Aim - The purpose of this study was to assess the prevalence of cardiophobia, its types and to evaluate the quality of life of patients with this disorder.
Methods - A consecutive series of 40 patients who satisfied the diagnostic criteria for cardiophobia were included in this study. Patients underwent the process of detailed case taking involving extensive evaluation of their mental state and life space.
1. In 29 patients (72.5%), a psychiatric diagnosis (mainly an anxiety disorder) antedated the onset of cardiophobia. Hence it was defined as secondary. The cardiorespiratory symptoms were part of the mental symptoms. In the remaining 11 patients (27.5%) cardiophobia was the primary disorder.
2. Patients with secondary cardiophobia reported significantly higher levels of anxiety, depression, social phobia, abnormal illness behavior and an impaired quality of life compared with patients with primary cardiophobia. This latter did not significantly differ in these variables (except for depression) from healthy control subjects matched for sociodemographic variables.
An 8 month follow-up revealed that patients with primary cardiophobia had a much better prognosis than those with secondary cardiophobia.
Homoeopathic Outlook - The homoeopathic approach towards this disorder is quite clear. It is a sickness and requires effective management. Majority of already diagnosed patients who come to a Homoeopath are on anti-depressants, tranquilizers, mood elevators or other allopathic, ayurvedic or unani medicines. When these patients demand homoeopathic care, then gradual tapering of the above drugs with replacement of so called specific dynamic remedies (acute palliatives and complimentaries) should be followed. Apart from psychotherapeutic measures and counseling, homoeopathic remedies play a significant role in alleviating this state of anxiety. Several rubrics are enlisted in various repertories that can be used for prescribing remedies in acute state like
But the final prescription remains the deep acting constitutional antimiasmatic remedy that needs to be administered, once the patient is settled along with proper repetitions. The management has to be strictly individualized for every patient. It will be foolish to treat the nosological labeling of Cardiophobia, since our therapy deals with the patient and not with the disease. Patients have to be prepared for receiving homoeopathic care. This is done by educating them (and their care takers) regarding the mode of therapeutics, disciplining the lifestyles so as to eliminate the possible maintaining causes. Avoidance of self medications should be explicitly outlined to the patient. Primary cardiophobia is a psoric mental state and it responds very well to homoeopathic methods of working. The cure rate is much higher. In Secondary cardiophobia – organic miasms take the upper hand especially the psoro-syphiltic and the syphilitic miasm. The cure rate in such cases is lower but palliation is very well possible.
So the final word is that the homoeo soldiers and homoeo armore is ready. Its time to uproot this evil – Cardiophobia.