What symptoms characterize somatoform autonomic dysfunction of the nervous system?

Somatoform autonomic dysfunction is a complex disease in terms of diagnosis. It has many symptoms of both a physical and mental nature. And patients suffering from it, feel the signs of the disease quite sharply, which violates their professional implementation. Therefore, in all that concerns the disease, it is necessary to understand in detail.

Overview of SVD disease

Somatoform autonomic dysfunction (SVD) is more often detected in men of draft age or in persons who undergo urgent dilation or participate in direct combat operations. This disease, which manifests itself in a mass of nonspecific symptoms and requires detailed diagnosis. Its goal is to exclude structural anomalies of the heart and arrhythmias, as well as lesions of the central nervous system.

It is believed that somatoform autonomic dysfunction is a persistent imbalance between the sympathetic and parasympathetic nervous system. SVD itself is divided into three types: SVD by cardiac, hypotonic and hypertonic type. They should be differentiated from heart disease, arterial hypo- and hypertension, which is solved in the course of the implementation of activities for conscription. For this reason, women have SVD less often than men and adolescents. Although in 80% of cases the diagnosis is not confirmed at the central medical and consulting commission.

Symptoms of SIDS

Somatoform dysfunction of the autonomic nervous system is manifested by a mass of nonspecific symptoms. Often they appear chaotically against the background of stress and pass in quiet situations. It is important that VDS can also be called a syndrome, since it includes a really large number of symptoms. They are manifested in the following variants of syndromes: cardiac, hypotonic, hypertonic. General symptoms, signs of dyspepsia, respiratory disorders, physical disadaptation can also be observed. These symptoms will be considered in detail.

Basics of diagnosis

The main criteria for diagnosis related to SVD are: the period of the presence of symptoms (more than 2 years) and the absence of hemodynamically significant or life-threatening violations of the structure of the heart or arrhythmias. Strictly speaking, all small cardiac abnormalities that do not lead to changes in heart cavities or rhythm disturbances can be combined.

The diagnosis of somatoform autonomic dysfunction can then be combined with, for example, tricuspid (mitral, pulmonary or aortic) insufficiency, a rare extrasystole, a transient syndrome of WPW or CLC. However, such patients should be observed 2 times a year to detect further violations. Obviously, most of the diagnoses of SVD exhibited by draftees and adolescents have no right to exist. Often, the diagnosis itself is made by a doctor without complaints on the basis of the presence of small structural disorders in the heart. Therefore, about 80% of diagnoses are disputed, and only complaints and concomitant pathologies and syndromes are of clinical importance.

Common symptoms of SVD

In a disease such as somatoform autonomic dysfunction, symptoms of a general nature are numerous. These are mood disorders, dysphoria, dysthymia, reluctance to perform any physical work, impaired appetite, muscle weakness, periodic headaches, mainly localized in the parietal and occipital region. Sometimes the patient is worried about dizziness and burning sensation in the epigastric region, not related to hunger or satiety.

Similar complaints characterize the asthenic syndrome of somatoform autonomic dysfunction. Patients, as a rule, are inactive, sometimes bezinitsiativnye and easily upset. Each of them is characterized by a trait with reluctance to take on new business. Most often they do not end. Paradoxically, however, introversion, which develops as a result of insignificant progress in sports or low physical activity, leads to the fact that children seek to compensate for this by studying. They remember well, but in stressful situations they think irrationally. Avoidance of stress and unwillingness to participate in cases that require emotional excitement is a characteristic feature of a patient with somato-functional autonomic dysfunction.

Physical load with SVD

Low tolerance to physical activity is a typical symptom of SVD. Patients are reluctant to undertake exercises in physical education classes, especially if it requires strength. As a rule, mobile games are given to such patients easily, whereas strength exercises cause a lot of difficulties. You can see that after running he has more pronounced dyspnea than other children of the same complexion. In addition, these patients get tired faster, their endurance is lower than that of others. Also, on the background of the load, respiratory or cardiac symptoms of the SVD, described below, may appear.

Cardiac (cardiac) complaints of patients

Somatoform dysfunction of the autonomic nervous system is manifested by numerous symptoms, which are caused by an imbalance between sympathy and parasympathy of the innervated organ. Cardiac complaints, as the body has vegetative innervation, are among the most important. The most typical symptoms of SVD from the heart and blood vessels are: cardiac pain, tachycardia, an increase or decrease in blood pressure.

The nature of pain in the heart is not specific for a particular disease. Pain, as a rule, stitching and sometimes pressing. Their localization is the base of the heart (3-6 cm to the left of the sternum) and the tip (5 cm to the left of the sternum on the 5th intercostal space). Tachycardia can be caused by emotional stress or physical stress. It is important that it develops disproportionately to the severity of the burden being transferred. For example, tachycardia appears immediately before the exercise or at the very beginning, and not as it grows.

It is important that the pain in the heart, if they have the character of burning and (or) squeezing and manifest 20-30 minutes, should be regarded as ischemic, which requires the recording of electrocardiography within the shortest period of time. This is due to the presence of such nosological forms as variant angina and cardiac syndrome X. With such pathologies, the probability of sudden coronary death is 50-100 times higher.

Hypotension and hypertension

Hypotension develops quite rarely. This is the most rare type of SVD, because the most common manifestations are cardiac or hypertonic types. Nevertheless, the hypotonic type of SVD is manifested by periodic drops in blood pressure on both hands. It is important that for the diagnosis of this type of disease requires the implementation of echocardiography and electrocardiography, which allow to exclude the presence of heart defects or arrhythmias. Fainting is also a sign of SVD, albeit nonspecific.

Hypertension is a more typical complaint. Patients are trying to increase the pressure before exercise, and not in the course of this. Pressure, as a rule, increases in isolation: up to 160 systolic blood pressure rises, while the dystolic remains the same. In view of the elasticity of the vessels in adolescents and young women whose somatoform autonomic dysfunction of the heart is diagnosed more often, diastolic blood pressure may decrease slightly.

The same is due to the imbalance of the sympathetic and parasympathetic nervous system, when norepinephrine expands the muscle arteries, reducing the peripheral resistance of the vascular bed. It is important that the pressure does not rise constantly, because the diagnosis of hypertension can not be set.

Respiratory complaints

With a disease such as somatoform dysfunction of the autonomic nervous system, the symptoms are also respiratory. Patterns of their occurrence are similar to those in the case of cardialgia, hypotension or hypertension. That is, respiratory complaints appear during the exercise. Also, what is specific for the SVD, they can appear after the completion of the exercise during the rest period. This distinguishes respiratory complaints from SVD from symptoms of bronchial asthma physical stress.

Examples of complaints with SVD: marked mixed dyspnoea at exercise or during rest period after its performance, a feeling of tightness in the chest and difficulty in inhaling. For comparison, with asthma, the exhalation is disturbed. Along with respiratory complaints with a disease such as somatoform dysfunction of the vegetative system, cardiac manifestations also appear. Their joint appearance is an informative, but non-specific indication that allows such a diagnosis.

Dyspepsia with SVD

With such a disease as somatoform dysfunction of the autonomic nervous system, the causes are plural. They hide in an imbalance between the parasympathetic and sympathetic nervous systems. And the entire gastrointestinal tract is also involved in this process, because it is completely innervated by the parasympathetic system. The wandering nerve regulates secretion in the stomach, pancreas, intestine. He is responsible for the motility and digestion. Therefore, with SVD often there is dyspepsia and pain in the abdomen.

Of the most frequent dyspeptic phenomena, one should distinguish nausea without vomiting, periodic pain in the epigastric region, which have the character of pressing or stitching. Their appearance does not depend on food intake: it is chaotic and is associated mostly with stress. Also, pain can be localized in any other part of the abdomen. They also appear suddenly or with physical exertion. These pains are not carried out in other parts of the abdomen and are not accompanied by fever, diarrhea, or vomiting.

It is important that the above symptoms occur in irritable bowel syndrome. It is believed that these diseases are different. However, with IBS, the cause is also the unbalanced motility of the large intestine. Therefore, it is likely that IBS should be considered a symptomatic complex of SVD. In addition, it is more common in people with SVD. Symptoms of the intestinal syndrome are: stool retention, bloating and rumbling in the abdomen.

Competent diagnosis of LED

With such a disease as somatoform dysfunction of the autonomic nervous system, the treatment is selected individually depending on the prevailing symptoms. The diagnosis of SVD can not be made without patient complaints, occurring 2 years or more, meeting the above criteria. It is also important to exclude all organic diseases: congenital (or acquired) heart defects, arrhythmias, thyroid disease, stomach ulcer (or duodenum), gastritis, Crohn's disease, intestinal diverticulosis.

Also, it is required to exclude possible mental illnesses, which are manifested by somatoform disorders. This means that the patient needs to do some research: make general and biochemical blood tests, general urine analysis, blood glucose and thyroid gland hormones, record ECG, perform echocardiography, FEGS, ultrasonography of brachiocephalic arteries and thyroid gland. Based on the results of the conducted studies, a conclusion is made as to whether the diagnosed symptom complex is a manifestation of SVD or is related to another disease.

Somatoform autonomic dysfunction: treatment

SVD is treated by several methods that combine pharmacotherapy, vitamin therapy, replenishment of the body's mineral balance, ergotherapy and physiotherapy. In pharmacotherapy, it is important to balance nootropics (or antidepressants) with cardiotropic drugs. An example is a combination of the drug "Fenibut" or "Noofen" in a dose of 250 mg 3 times a day for 2 months with "Tiotriasoline" at 100 mg twice a day for 2 months. On the appointment of antidepressants should consult with a psychiatrist who will assess the age and potenial risk of drugs for the patient.

With a disease such as somatoform dysfunction of the autonomic nervous system, treatment also includes mineral therapy. It has been proven that, for example, mitral valve prolapse or failure of other valves is associated with interstitial imbalance of magnesium. Replenishment of its levels allows you to reduce the manifestations of cardiac complaints and the severity of hypotension or hypertension.

Vitaminotherapy, especially the replenishment of vitamins C, E and D, as well as B1, B2, B5 and B6, is a rational requirement. However, these vitamins are poorly absorbed when taken together. Therefore, the course of treatment is required: 1 month vitamins of groups C, E and D, and then 1 month vitamins B1 and B2, then 1 month B6 and B5. Of course, since in the large intestine of humans these vitamins are synthesized themselves, one should also eat fresh vegetables and herbs without heat treatment.

Since in the development of SVD the low interest in one's own health and neglect of the needs of the organism play a role, the replenishment of vitamins and minerals makes it possible to reduce the severity of the symptoms. Labor therapy in the course of sanatorium treatment (paid, because in the clinic vouchers are not given to patients with SVD) will have a much more stable effect. But the patient is better to explain that even rest is a cure for him, if only because during rest he has no complaints.

Somatoform dysfunction of the autonomic nervous system (ICD 10)

In the international classification, this disease has been present since 1993. This pathology is found all over the world and does not depend on the characteristics of a particular race or nation. In the ICD 10 somatoform autonomic dysfunction is revised in the V and VI rubrics. The first includes "Mental and behavioral disorders" (code F0-99), and the second - "Neurotic, stress-related and somatoform disorders" (code F45-F48).

The heading F45 includes the following pathologies: somatized disorders, undifferentiated somatoform disorder, directly somatoform autonomic dysfunction, hypochondriacal disorder, stable somatoform pain disorder and other unspecified disorders of nervous regulation. The somatoform autonomic dysfunction is encoded by code F45.3 and requires the elimination of organ damage innervated by the peripheral autonomic nervous system.

Conclusion

Many scientists today are convinced that somatoform autonomic dysfunction should be considered in more detail. This disease has an effect on the patient's social adaptation. At the same time, in a number of situations, the combined manifestation of SVD and structural anomalies in the sperton was proved. A wide practice of echocardiography made it possible to find out that the presence of an additional chord of the left ventricle and a mitral valve prolapse of low degrees with minimal regurgitation. The latter pathologies are complicated by arrhythmias and lead to congestive heart failure with age.

This means that somatoform autonomic dysfunction should be regarded as a symptom complex (syndrome), requiring the physician to further diagnose, aimed at identifying concomitant pathologies. Although in its pure form, SVD is a neurogenic disease that is associated with imbalance between the sympathetic and parasympathetic peripheral nervous system. Also, in view of the social importance of pathology, it is important to establish clear diagnostic criteria for SVD. This will make it possible to differentiate psychogenic and somatic diseases when carrying out activities for conscription for urgent military service.