Dtsch Med Wochenschr 2022; 147(10): 604-612
DOI: 10.1055/a-1554-1706
Dossier

Funktionelle kardiovaskuläre Beschwerden

Functional cardiovascular symptoms
Peter Henningsen
,
Karl-Ludwig Laugwitz

Patienten mit kardiovaskulären Beschwerden, die nicht kardiologisch organisch bestätigt werden können, werden nicht selten mit der Aussage „Sie sind herzgesund“ entlassen. Das ist zwar kurzfristig beruhigend, aber damit sind die Beschwerden weder erklärt noch leitet sich daraus eine Behandlungsidee ab. Der folgende Beitrag beleuchtet psychosoziale Faktoren und psychosomatische Wechselwirkungen, die zu funktionellen kardiovaskulären Beschwerden führen.

Abstract

This review provides an update on the diagnosis, differential diagnosis and management of functional cardiovascular symptoms. Typical heart-related symptoms like non-cardiac chest pain and palpitations are frequently complemented by other symptoms like dyspnea, sweating, trembling, dizziness and also further somatic symptoms like pain and fatigue. Functional cardiac symptoms are frequent, with rates of up to 30 % in chest pain units. The differential diagnosis comprises gastrointestinal disorders like gastro-esophageal reflux disease and also mental disorders, particularly panic and other anxiety disorders. Successful management depends on an attitude of realizing and confirming the reality and seriousness of the symptoms despite the absence of a clear structural organic cause. Good cooperation with psychotherapists is helpful for stepped care strategies that start with supportive communication with the patient and biopsychosocial self-help activities, leading, if necessary, to formal psychotherapy.



Publication History

Article published online:
11 May 2022

© 2022. Thieme. All rights reserved.

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