A heart neurosis is a mental disorder in which sufferers live constantly in the fear of suffering a heart attack. Continue reading!


A cardioneurosis is a mental disorder in which sufferers live constantly in the fear of suffering a heart attack. It comes to panic attacks, fear of death and not infrequently to a complete social withdrawal. The classic symptom of cardiac neurosis is cardiac pain, which is not due to any organic cause. Read here what causes heart neurosis and how it is treated.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. F40

Product Overview


  • description

  • symptoms

  • Causes and risk factors

  • Examinations and diagnosis

  • treatment

  • Disease course and prognosis

Heart Neurosis: Description

Cardiac neurosis (cardiac phobia, cardiophobia, Da Costa syndrome) is a special form of anxiety disorder. Those affected live in constant fear of suffering a heart attack. This fear is often accompanied by physical factors such as palpitations, heart pains or heart stumbling and affects the entire life of those affected. It can increase to panic attacks and a real fear of death.

A classic indication of cardiac neurosis is that a cardiologist can not find a physical cause of the condition. Therefore, cardiac neurosis or anxiety is one of the somatoform, autonomic dysfunctions. This means that the physical symptoms of cardiac neurosis have no physical cause, but are psychologically conditioned. Sufferers pay more attention to themselves because of their fear, and they perceive every little change in the body as fear. This fear then triggers the actual complaints. It is not uncommon for victims to enter a vicious circle of anxiety and physical symptoms that they can not break on their own.

It is important to note that cardiac neurosis may develop into actual heart disease over time. Likewise, a cardiac neurosis may also be an accompanying symptom of a physical illness. For example, people who have once suffered a heart attack often develop heart neurosis in fear of a re-infarction.

Heart neurosis: frequency

In Germany, about 100,000 people suffer from heart anxiety. About 15 percent of all patients who consult a doctor for heart failure have heart neurosis; most of them are men. A heart neurosis occurs especially in those over 40 years old. Younger people seldom suffer from it.

Heart neurosis: symptoms

The most important symptom of cardiac neurosis is the fear of a heart attack that constantly accompanies the person. This fear can become so strong that it comes to panic attacks and fear of death.

As is often the case with anxiety, it speeds up the pulse of those affected and increases blood pressure. This can be accompanied by tachycardia, heart pain or heart stumbling. In addition, dizziness, shortness of breath, sweating and tremors can occur in cardiac neurosis. Patients usually complain of several symptoms that alternate.

The symptoms of cardiac neurosis can also spread to other organ systems: Typical are digestive problems and stomach aches. Sleep disorders are also a common concomitant symptom of cardiac neurosis.

Social withdrawal

A heart neurosis is above all a mental problem, accordingly affected sufferers also mentally. The fear of the heart attack outweighs all other feelings in everyday life. Affected persons suffer from inner restlessness, live in a constant restraint and often show depressive symptoms. They try to avoid all physical exertion, excitement or stress for fear that it could otherwise lead to a heart attack. In most cases, the social environment such as family or work colleagues is also included in this fear, since those affected believe they can not survive on their own. Many lose all confidence in their abilities and strengths. Relatives and friends often do not know how to behave properly in order to avoid anything that could upset the person concerned.

Anyone who suffers from a heart neurosis feels, despite all the attention it receives, most of the time misunderstood and is convinced that no one, even a doctor, can help him.

As a result, many sufferers withdraw themselves. Sometimes even friends from helplessness and helplessness increasingly turn away from the person concerned. The social loneliness subsequently intensifies the anxiety and symptoms of cardiac neurosis.

Cardiac Neurosis: Causes and Risk Factors

Cardiac neurosis is a psychosomatic disorder. This means that the symptoms and anxiety that occur do not have a physical cause, but a mental one.

There are several theories where to look for the causes of heart neurosis:

  • Causes in childhood: The literature often describes a disturbed relationship of the parents to their child as a risk factor for a heart neurosis later in life.Different types of relationships can play a role here: mothers are often described as overprotective and too dominant. Likewise, early disconnection or neglect may be the reason for the disorder where children have no opportunity to learn coping skills.
  • Diseases in the social environmentScientists believe that the risk of heart neurosis is greater if a close relative or friend already has suffered from heart neurosis or actual heart trouble. Thus, the fearful handling of the heart is lived in the environment and taken over by those affected.
  • mortality: Even deaths in their own environment can cause a heart neurosis. The death of a relative or acquaintance makes the person concerned aware of their own mortality. Many are afraid of death and respond to this fear with excessive caution and the belief that they will actually die soon.
  • Conflicts and problemsUnresolved problems and conflicts in everyday life can also contribute to the development of cardiac neurosis. They affect the heart function in the normal way: the heart beats faster. This reaction is often misinterpreted and interpreted as a serious illness. So then the other conflicts take a back seat.
  • Pre-existing conditions: Cardiac neurosis can also be a consequence of a previous illness. For example, people who have suffered a heart attack often develop an overwhelming fear of a new heart attack.

How does a heart neurosis develop?

All these theories have a common point: People with a heart neurosis are usually very sensitive, insecure and have little self-confidence. Thus, they often misinterpret a normal heart reaction and interpret it as the onset of a disease. The heart is very sensitive to all mental changes: For example, it starts to beat more than usual in anxiety, stress or everyday problems. Often you sweat more at the same time or start to shiver.

Cardiac neurosis overestimates these symptoms. The sufferer then begins to pay more attention than any other person to changes in their body. This leads to a vicious circle of misinterpreted heart actions and fear that can no longer be breached on its own.

Physical requirements

In addition, most of those affected have certain physical conditions that promote the development of cardiac neurosis. While other people develop problems with their stomach, migraines or sleep disorders during stress and strain, people with cardiac neurosis react with heart problems.

Cardiac neurosis: examinations and diagnosis

The diagnosis of cardiac neurosis is very difficult and can last for many years. Affected persons assume that their complaints have a physical and thus demonstrable cause. In fact, the cause of cardiac neurosis is in the psyche and can therefore be detected neither with imaging nor with metrological methods. Nevertheless, it is necessary to rule out a physical cause of the problems to clarify a cardiac neurosis by means of examinations.

Physical examination

The physical exam usually involves first making a resting and exercise ECG. These examinations are painless for the patients. Only eight electrodes are attached to the arms and legs and over the chest. So the heart activity is recorded. Cardiac arrhythmias can be so clearly recognized.

Also, a blood test is made in clarification of a cardiac neurosis.

If no malfunctions are detected during these initial examinations, more complex examinations can be used, such as a cardiac catheterization, magnetic resonance imaging (MRI) or cardiac ultrasound.

Find the doctors in all these investigations no organic cause of the complaints, the suspicion that a psychological cause and thus a heart neurosis is corroborated. Decisive information for the diagnosis is provided by the conversation with the patient. Then usually a psychiatrist or a psychologist is called in.

Key symptom anxiety

In conversations with the patient, it is above all the topic of fear that gives the psychologist the decisive clue. People with heart neurosis are strongly focused on their own hearts and their fear of the disease. It can be a real fear of a heart attack, fear of air distress or the fear of one's own death. In some cases, the theme of anxiety is also barely palpable, and it relates more generally to the daily lives of those affected.

It is also typical for heart neurosis that sufferers like to tell a lot about themselves and report in detail about their symptoms. The symptoms are not necessarily limited to the heart. So also problems with the digestion, with the stomach or sleep disturbances load those concerned. Also previous mental complaints are frequently reported.

If the diagnosis goes on for many years, a change from "good" and "bad" times becomes clear to most people affected.During normal everyday life, or when other problems accumulate at the workplace, for example, heart problems usually get worse. On holiday, on the other hand, those affected are usually much better off. Even very quick mood changes can occur.


Heart neurosis can be an accompanying symptom of actual heart disease. Similarly, even in patients who initially have no organic discomfort, can develop from a cardiac neurosis, an organic disease.

There is also another difficulty: the majority of patients strictly reject the idea that their discomforts may have a psychological cause and insist on an organic cause. The affected people do not conceive of their ailments such as palpitations, but they are actually present. If the physical examination then provides no explanation, sufferers quickly lose confidence in their doctor and seek out more doctors. They are accompanied by the feeling of being misunderstood by the whole world and not getting enough attention - typical signs of a heart neurosis. At the same time, the fear of dealing with the real problems can also play a role.

Heart neurosis: treatment

Since a cardiac neurosis is psychologically conditioned, its treatment belongs to the hands of a psychotherapist or a physician for psychosomatic medicine and psychotherapy.

The first step in cardiac neurosis treatment is made by the family doctor or heart specialist (cardiologist). After he has been able to rule out a physical cause of the complaint, he must carefully familiarize the person concerned with the idea of โ€‹โ€‹a psychological cause. Since sufferers often vehemently deny this and insist on an organic cause, the enlightenment can take many weeks or even years to complete. Patients who feel misunderstood often change doctors. Then all examinations are repeated and the beginning of the treatment is delayed again. It is important that the doctor takes the patient seriously and does not dismiss the symptoms as a fancy. Helpful in this are detailed explanations about the frequency, consequences, course and background of a heart neurosis.

Improvement of the symptoms

Next, the attending physician looks after the improvement of heart neurosis symptoms such as palpitations. This includes the teaching of relaxation techniques (such as progressive muscle relaxation, autogenic training), strategies for coping with illness and favorable behaviors that the person concerned can use when it comes to heart problems.

Treatment of the underlying problems

The basis of treatment of cardiac neurosis is psychotherapy. It is important to make it clear to the person concerned that the symptoms that are actually there, but not physically conditioned and also mostly harmless.

Depending on the problematic and personality of the patient, there are two options to choose from: cognitive behavioral therapy and psychodynamic therapies, for example psychoanalysis. Also a mixed form with elements of both is possible.

As part of a cognitive behavioral therapy People with cardiac neurosis learn strategies for how to behave when heart problems occur. Above all, movement-therapeutic elements are important: sufferers experience on their own body that their heart cope with physical effort, without being harmed. Also, the return to a normal everyday life with light sports units such as jogging, walking or swimming are among them. This regains confidence in one's own body and enables one to better cope with fears. As a result, the fear of a heart attack disappears, and the patient dares to do more - both physically and mentally.

Psychodynamic procedures They are based on the patient's understanding of the role his personal history and important caregivers played in the development of cardiac neurosis. The processing of such experiences and the gain in mental stability and self-confidence can enable him to overcome the symptoms.

Medical therapy

At the beginning of the cardiac neurosis therapy, the heart complaints can be additionally treated with medication. Betareceptor blockers (beta-blockers) reduce the tachycardia. In the long term, however, they are not suitable due to various side effects. In some cases tranquilizers (tranquillizers) or antidepressants are also prescribed. Also, they are not suitable for long-term therapy, since they can make dependent.

Cardiac neurosis: disease course and prognosis

As with most other diseases, cardiac phobia also applies: the earlier the disease is recognized, the better the chances of recovery!

If diagnosed early, cardiac neurosis can often be completely cured by psychotherapy. The therapy may take many years to complete. In addition, it is very rare that cardiac neurosis is detected early. It often takes years for those affected to receive the right treatment.

The longer the symptoms of cardiac neurosis persist, the more likely they become chronic. This complicates the therapy. Chronic cardiac neurosis develops in about half of all affected persons.

Since a cardiac neurosis can also develop an actual heart disease, it is necessary for those affected to undergo regular physical examinations during psychotherapy. Thus, with organic changes can be started immediately with a corresponding therapy.

However, psychotherapeutic treatment can still help if someone has been suffering from heart neurosis for many years. Even if the symptoms do not disappear completely - the person affected can at least develop strategies to get a better grip on the fear and learn to believe in his strengths again. That can improve the quality of life cardioneurosisPatients improve significantly.

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