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Da Costa's syndrome
Specialty	Psychiatry

Da Costa's syndrome, which was colloquially known as soldier's heart, is a syndrome with a set of symptoms that are similar to those of heart disease, though a physical examination does not reveal any physiological abnormalities. In modern times, Da Costa's syndrome is considered the manifestation of an anxiety disorder and treatment is primarily behavioral, involving modifications to lifestyle and daily exertion.

The condition was named for Jacob Mendes Da Costa, who investigated and described the disorder during the American Civil War. It is also variously known as cardiac neurosis, chronic asthenia, effort syndrome, functional cardiovascular disease, neurocirculatory asthenia, primary neurasthenia, subacute asthenia and irritable heart.

Classification

The World Health Organization classifies this condition as a somatoform autonomic dysfunction (a type of psychosomatic disorder) in their ICD-10 coding system. In their ICD-9 system, it was classified under non-psychotic mental disorders. The syndrome is also frequently interpreted as one of a number of imprecisely characterized "postwar syndromes".

There are many names for the syndrome, which has variously been called cardiac neurosis, chronic asthenia, effort syndrome, functional cardiovascular disease, neurocirculatory asthenia, primary neurasthenia, and subacute asthenia. Da Costa himself called it irritable heart and the term soldier's heart was in common use both before and after his paper. Most authors use these terms interchangeably, but some authors draw a distinction between the different manifestations of this condition, preferring to use different labels to highlight the predominance of psychiatric or non-psychiatric complaints. For example, Paul writes that "Not all patients with neurocirculatory asthenia have a cardiac neurosis, and not all patients with cardiac neurosis have neurocirculatory asthenia." None of these terms have widespread use.

Symptoms

Symptoms of Da Costa's syndrome include fatigue upon exertion, shortness of breath, palpitations, sweating, and chest pain. Physical examination reveals no physical abnormalities causing the symptoms.

Causes

Da Costa's syndrome is generally considered a physical manifestation of an anxiety disorder.

Diagnosis

Although it is listed in the ICD-10 under "somatoform autonomic dysfunction", the term is no longer in common use by any medical agencies and has generally been superseded by more specific diagnoses.

The orthostatic intolerance observed by Da Costa has since also been found in patients diagnosed with chronic fatigue syndrome and mitral valve prolapse syndrome. In the 21st century, this intolerance is classified as a neurological condition. Exercise intolerance has since been found in many organic diseases.

Treatment

The report of Da Costa shows that patients recovered from the more severe symptoms when removed from the strenuous activity or sustained lifestyle that caused them.

Other treatments evident from the previous studies were improving physique and posture, appropriate levels of exercise where possible, wearing loose clothing about the waist, and avoiding postural changes such as stooping, or lying on the left or right side, or the back in some cases, which relieved some of the palpitations and chest pains, and standing up slowly can prevent the faintness associated with postural or orthostatic hypotension in some cases.

History

Blah blah blah so what if people had "de costa's syndrom" or whatever it is called. theyre just wierdos that are scared of blood.

References

1. ^ "2008 ICD-9-CM Diagnosis 306.* - Physiological malfunction arising from mental factors". 2008 ICD-9-CM Volume 1 Diagnosis Codes. Retrieved 2008-05-26. Neurocirculatory asthenia is most typically seen as a form of anxiety disorder.
2. Engel CC (2004). "Post-war syndromes: illustrating the impact of the social psyche on notions of risk, responsibility, reason, and remedy". J Am Acad Psychoanal Dyn Psychiatry. 32 (2): 321–34, discussion 335–43. PMID 15274499.
3. Clark MR, Treisman GL (eds.) (2004). Pain And Depression: An Interdisciplinary Patient-centered Approach (Series: Advances in Psychosomatic Medicine, vol. 25). Basel: Karger. p. 176. ISBN 3-8055-7742-7. {{cite book}}: |author= has generic name (help)
4. "Neurasthenia". Rare Disease Database. National Organization for Rare Disorders, Inc. 2005. Retrieved 2008-05-28.
5. Paul Wood, MD, PhD (1941-05-24). "Da Costa's Syndrome (or Effort Syndrome). Lecture I". Lectures to the Royal College of Physicians of London. British Medical Journal. pp. 1(4194): 767–772. Retrieved 2008-05-28.{{cite web}}: CS1 maint: multiple names: authors list (link)
6. Cohen ME, White PD (1951). "Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome)". Psychosom Med. 13 (6): 335–57. PMID 14892184. Retrieved 2008-05-28.
7. ^ Paul O (1987). "Da Costa's syndrome or neurocirculatory asthenia". Br Heart J. 58 (4): 306–15. PMID 3314950. Cite error: The named reference "pmid3314950" was defined multiple times with different content (see the help page).
8. Da Costa, Jacob Medes (January 1871). "On irritable heart; a clinical study of a form of functional cardiac disorder and its consequences". The American Journal of the Medical Sciences (61): p.18–52. {{cite journal}}: |access-date= requires |url= (help); |pages= has extra text (help)
9. Selian, Neuhoff (1917). "XX". Clinical Cardiology. New York: MacMillan. p. 255.; cited on "Da Costa's Syndrome". vlib.us. Retrieved 2007-12-18.
10. "Dorlands Medical Dictionary:Da Costa syndrome". Retrieved 2008-05-26.
11. Online Mendelian Inheritance in Man (OMIM): Orthostatic Intolerance - 604715

• Somatoform disorders
• Anxiety disorders