A comparison between electrocardiographic observations during an attack of neurocirculatory asthenia and psychological tests

Abstract

In order to clarify the relationship between cardiovascular complaints and electrocardiographic changes during an attack of neurocirculatory asthenia (NCA), 64 patients with cardiovascular complaints, but without organic heart disease, were studied. The findings of the patient-activated pocket electrocardiograph (PECG) were analyzed and compared with the results of psychological tests [Cornell Medical Index (CMI) and Yatabe-Guilford (Y-G) test].
Among the 64 patients studied, 307 attacks were recorded by PECG. Subjective complaints during the attacks were as follows : palpitation in 129 attacks, 41 patients, respiratory symptoms in 85 attacks, 33 patients, chest pain in 138 attacks, 45 patients and other symptoms in 120 attacks, 34 patients. Heart rate (HR) during the attacks was significantly higher than basal HR (p<0.01).
HR was higher during the episodes of palpitation and respiratory symptoms than during chest pain and other symptoms with statistical significance.
HR during the episodes of palpitation and respiratory symptoms was significantly higher than basal HR (p<0.001). However, HR during chest pain and other symptoms was not significantly different from basal HR.
All of the basal HR, HR during attacks and maximum HR in the abnormal CMI group were significantly higher than those in the normal CMI group (p <0.01, p<0.001, p<0.01, respectively).
In Y-G test, only HR during attacks in the abnormal group was significantly higher than in the normal group (p<0.01).
There was no significant difference in HR during episodes of palpitation and respiratory symptoms between the normal and abnormal CMI groups. However, HR during chest pain and other symptoms was significantly higher in the abnormal CMI group than in the normal CMI group.
Concerning ECG findings other than HR change, ventricular premature contractions were found in 17 attacks, 5 patients, T wave inversion in 5 attacks, 4 patients, atrial premature contractions in 5 attacks, 2 patients, sinus arrhythmia in 7 attacks, 2 patients, ST depression (J type) in 1 attack, 1 patient, and ST elevation in 2 attacks, 1 patient.
Thirty-two cases showed CTR smaller than 42%, indicating that the small heart itself is a possible cause of cardiovascular complaints of NCA.
A statistically significant difference was also found between the respiratory abnormalities of the normal and abnormal CMI groups (p<0.05).
In summary, (1) The most characteristic ECG change during attacks of NCA is change in heart rate. (2) Heart rate changes are related to the kind of symptoms and psychological test results.