Diagnosis dump: why vegetovascular dystonia is wrongly diagnosed in patients

One of the most widespread diagnoses of the Soviet era was vegetovascular dystonia. This condition was actually blamed for various ailments that could not be explained. VSD was diagnosed to those who for unknown reasons suffered from pressure spikes or headaches. What hides behind the nonexistent diagnosis, why it is important to establish the causes of unpleasant syndromes and how to get rid of them - in the material "Izvestia".

Under the pressure of problems

Vegetative dystonia is mistakenly considered a disease of one of the departments of the nervous system - that part of it, which is responsible for involuntary functions and reactions of the body, says the doctor-neurologist clinic "Be Healthy" Galina Novoselova. This department is called autonomous or vegetative.

- Thanks to the autonomic nervous system (ANS), the heart beats, blood pressure, digestion, respiratory rate, pupil width changes, sweat is secreted, and other things happen that we cannot control consciously," says Galina Novoselova.

The autonomic nervous system (ANS) controls the work of all internal organs, glands of internal and external secretion, blood and lymphatic vessels, comments therapist Ksenia Fedorova, NMC "Medical and Rehabilitation Center" of the Ministry of Health of Russia. On its smooth operation depends on the quality of our lives.

In turn, the ANS is divided into two main departments: sympathetic and parasympathetic systems.

- The sympathetic system can be called the stress nervous system. We need it for a successful escape from the saber-toothed tiger, - ironizes the therapist. - That is, in moments of danger thanks to it increases blood pressure, heart rate and respiratory rate, blood rushes to the muscles, so that they can work more intensely and the person was able to escape.

The parasympathetic department is practically the antipode of the sympathetic, it is designed for "licking" wounds and recovery, explains Fedorova.

Thus, the autonomous nervous system is actively involved in the body's response to our emotional state and what is happening around us, emphasizes Galina Novoselova. In order for a person to run away from danger or fight, it not only starts to beat harder heart, increases blood pressure and breathing rate, but even suspends digestion. If the body is working properly, such manifestations are justified by the situation and the person will not experience them for a long time, much less go to the doctor in search of causes.

Hidden problems

The therapist draws attention to the fact that in some cases people have an imbalance of the sympathetic and parasympathetic systems. This can happen when experiencing prolonged and intense emotional stress, a severe viral or bacterial infection, surgery, moving to a different climate or time zone.

- And then even a small trigger can cause stress. "There is no tiger, we sit on a chair, and we have high blood pressure, frequent pulse, we breathe intensely and can not cope with it," comments Fedorova.

Without an objective reason, unpleasant symptoms often appear in people with high anxiety. And that's when they go to the doctor with all sorts of complaints: heart pounding, high blood pressure, intense sweat, it seems like not enough air. According to Novoselova, such and similar manifestations in the USSR and called vegetovascular, or neurocirculatory, dystonia. In this diagnosis they tried to "stick" everything that was unclear, sometimes without even realizing the essence of the question. VSD was diagnosed with palpitations, chills, sweating, pallor, headaches, tinnitus, weakness, fatigue, fainting, tics, digestive disorders. Hypertension and hypotension, heart pain and heart rhythm disturbances were also considered to be its signs.

- Over time, experts have realized that the diagnosis of VSD can hide angina pectoris, tension headaches, migraines, thyroid disorders, panic attacks, anxiety disorders and depression. And this is by no means a complete list of real diseases," Galina Novoselova explains.

Thus, in the international classification of diseases there is no diagnosis of "vegetovascular dystonia". But what to do if a person comes to the doctor with a large number of various complaints, which sometimes do not correspond to the age of the patient, and to establish the causes of suffering for a long time is not possible?

Our doctors now often diagnose such patients as "disorder of the autonomic nervous system unspecified". But it makes no sense to limit oneself to such a verdict - it is necessary to look for the true causes of the ailment. Ksenia Fedorova also calls the dysfunction of the autonomic nervous system a collective concept, a kind of "dump" diagnoses. Only the most meticulous doctor can get to the bottom of the problem.

- First of all, it is necessary to exclude the so-called organic pathology - the true problem of the organ, which the patient complains about. Without such a step, the diagnosis of VSD is ineligible, as it is considered a diagnosis of exclusion," comments Ksenia Fedorova.

According to Galina Novoselova, behind the diagnosis of "disorder of the autonomic nervous system unspecified" can hide true conditions of the autonomic nervous system lesions. For example, Gorner's syndrome (hypohidrosis - weakening of sweating, miosis - constriction of the pupil, ptosis - drooping eyelid, enophthalmos - also constriction of the pupil).

In search of the source of health problems, doctors conduct a thorough examination. For example, if a person has a headache, then neuroimaging with MRI, duplex examination of carotid and vertebral arteries and veins is performed.

- And if there are complaints of gastroenterological plan (abdominal bloating, nausea, heaviness under the spoon, unstable stool), the patient is checked for infections, perform an endoscopic examination (EGDS, colonoscopy). Blood tests exclude deficiencies of iron, B12, folic acid, magnesium. Their deficiency can cause general weakness, fatigue, which are very often complained of by such patients, - continues Ksenia Fedorova.

The next step - doctors briefly explain to the patient what is the autonomic nervous system, what it is "busy" in the body and what in a particular case caused its imbalance. Having such information leads to understanding of what is happening and compliance, that is, to the desire to fulfill the doctor's recommendations, says the therapist.

Burnout and panic attacks

In most cases, behind the so-called vegetovascular dystonia (ordinary people still use this term) are unrecognized disorders of the psycho-emotional sphere, says Galina Novoselova.

- One of the most common conditions that arise in young people is a panic attack. It can be accompanied by a variety of symptoms - suddenly the heart beats strongly, shortness of breath, high blood pressure. The person feels a tremor in the body, dizziness, feels waves of heat or cold," Novoselova comments.

According to the neurologist, it is not necessary that all symptoms are present - one state or the other may prevail. If a person has mental problems, he experiences very negative feelings: sudden anxiety, panic, fear of death and in rare cases fear of going crazy.

- Often panic attacks are provoked by long journeys, crowds of people, going to the store," Novoselova comments. - Importantly, panic attack is not a diagnosis but a symptom complex.

The doctor is advised to clarify within which condition the panic attacks are present. For this, it is worth seeking advice from a psychiatrist or psychotherapist.

- It happens that the patient feels a sharp, compressive and prolonged pain in the chest in the projection of the heart. Sometimes it occurs in combination with other symptoms (for example, accompanied by shortness of breath). Sometimes the pain radiates to one arm (mainly the left arm), both arms or under the shoulder blade," warns the expert.

Sometimes a person should be treated not with classical medications (for blood pressure and heart palpitations), but with sedative drugs, which will lower blood pressure and quiet the pulse, emphasizes Ksenia Fedorova.

From the therapist's point of view, physical rehabilitation methods are also important: physical therapy, walking, swimming, healthy sleep. Psychotherapy consultations help to effectively improve the quality of life.