What Is Cardiac Neurosis? Understanding Symptoms and Triggers

Cardiac neurosis, also known as cardiovascular anxiety or functional heart disorder, is a type of neuropsychiatric condition characterized by prominent cardiac-like symptoms in the absence of any structural heart disease. This condition primarily affects individuals with high levels of stress, anxiety, or emotional sensitivity, leading them to experience distressing physical sensations that mimic heart problems. Despite the alarming nature of these symptoms, they are not caused by coronary artery disease, myocardial infarction, or other organic cardiac conditions.

Common Symptoms of Cardiac Neurosis

Chest Pain: Different from Heart Disease

One of the most frequently reported symptoms is chest pain. However, unlike angina or ischemic chest pain associated with coronary heart disease, the discomfort in cardiac neurosis tends to be brief, sharp, or stabbing in nature. It often occurs unpredictably and is not triggered by physical exertion, emotional stress, cold exposure, or exercise—factors that typically provoke true cardiac chest pain. Instead, this pain may suddenly appear at rest, last only seconds, and then disappear without explanation. Patients often describe it as a "pinprick" or "jumping" sensation rather than the crushing or pressure-like pain seen in actual heart conditions.

Palpitations: Racing or Pounding Heartbeat

Heart palpitations are another hallmark symptom. Individuals may feel their heart racing, pounding forcefully, or skipping beats—even when their heart rhythm is normal. These sensations can create significant anxiety, leading to a vicious cycle where fear of having a heart attack intensifies the perception of symptoms. Unlike arrhythmias caused by electrical disturbances in the heart, neurotic palpitations usually occur at rest and are closely linked to heightened awareness of bodily functions, especially during periods of stress or hypervigilance.

Chest Tightness and Shortness of Breath

Many patients report persistent feelings of chest tightness, breathlessness, or an inability to take a deep, satisfying breath—a phenomenon sometimes referred to as "sighing respiration." This sensation typically arises during moments of solitude or inactivity, contrary to organic heart disease, where dyspnea worsens with physical activity, emotional excitement, or exertion due to increased myocardial oxygen demand. In cardiac neurosis, breathing difficulties do not correlate with exertion and may even improve with light exercise or distraction.

Key Differences Between Functional and Organic Heart Conditions

A crucial distinction lies in the relationship between symptoms and activity. While genuine heart conditions like coronary artery disease or heart failure produce symptoms under physical strain, those with cardiac neurosis often find relief through movement. Paradoxically, remaining sedentary or focusing on bodily sensations tends to amplify discomfort. Emotional states such as anxiety, panic, or depression play a central role in triggering or worsening episodes, highlighting the mind-body connection inherent in this disorder.

Diagnosis and Management Approach

Because the symptoms closely resemble those of serious heart disease, thorough medical evaluation—including ECG, echocardiogram, and stress testing—is essential to rule out life-threatening conditions. Once organic causes are excluded, the focus shifts to psychological and lifestyle interventions. Cognitive behavioral therapy (CBT), mindfulness techniques, regular aerobic exercise, and stress management strategies have proven effective in reducing symptom frequency and improving quality of life.

In conclusion, cardiac neurosis is not a heart disease but a manifestation of psychological distress expressed through physical symptoms. Recognizing its non-cardiac origin empowers patients to seek appropriate care, break the cycle of fear, and regain control over their well-being.