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Psychological stress and cardiovascular diseases: clinical case

https://doi.org/10.21518/2079-701X-2022-16-23-110-116

Abstract

In the modern world, stress occupies a leading place among significant problems for humanity, being an etiological factor of about 80% of diseases. Social, physical and psychological factors can act as stressors that influence and determine the non-specific response of the body. In most cases, the nonspecific stress-induced reaction of the body is manifested by the picture of psychovegetative syndrome, an important component of which is the activation of the sympathetic nervous system. In a prolonged stress situation, psychovegetative syndrome can be a manifestation of stress-induced anxiety. Anxiety is detected in more than 25% of patients with a general somatic profile. Stress-induced reactions and anxiety can subsequently contribute to the development of psychogenic somatic pathology, including the cardiovascular pathology. Acute or chronic stress situation increases the risks of developing arterial hypertension, coronary heart disease, heart rhythm disorders. In the presence of background cardiac pathology, stress-induced reactions contribute to the deterioration of its course and reduce the effectiveness of treatment. The above indicates the need for a comprehensive assessment of the condition of patients with a general somatic profile. The active use in practical medicine of psychometric and psychodiagnostic scales for anxiety and depression is shown to assess the mental status of patients. When detecting stress-induced reactions or comorbid psychopathology, inclusion of psychotropic drugs, including antipsychotics (alimemazine), is indicated in the complex therapy. Timely administration of alimemazine in patients with a general somatic profile stops psychovegetative manifestations, has positive somatotropic effects due to the multimodal mechanism of action of the drug. In this clinical case, the use of alimemazine in a patient with hypertension, rhythm disorders and comorbid anxiety is presented.

About the Authors

E. Yu. Ebzeeva
Russian Medical Academy of Continuous Professional Education
Russian Federation

Elizaveta Y. Ebzeeva - Cand. Sci. (Med.), Associate Professor, Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993



O. D. Ostroumova
Russian Medical Academy of Continuous Professional Education; Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Olga D. Ostroumova - Dr. Sci. (Med.), Professor, Head of Department of Therapy and Polymorbid Pathology named after Academician M. S. Vovsi, Russian Medical Academy of Continuous Professional Education; Professor of Department for Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University).

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 8, Bldg. 2, Trubetskaya St., Moscow, 119991



E. V. Mironova
Central Clinical Hospital “RZD-Medicine”
Russian Federation

Elena V. Mironova - Cand. Sci. (Med.), Head of Cardiology Department, Central Clinical Hospital “RZD-Medicine”.

84, Volokolamsk highway, Moscow, 125367



N. M. Doldo
Central Clinical Hospital “RZD-Medicine”
Russian Federation

Nikolai M. Doldo - Cand. Sci. (Med.), Head of Therapeutics Department, Central Clinical Hospital “RZD-Medicine”.

84, Volokolamsk highway, Moscow, 125367



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For citations:


Ebzeeva EY, Ostroumova OD, Mironova EV, Doldo NM. Psychological stress and cardiovascular diseases: clinical case. Meditsinskiy sovet = Medical Council. 2022;(23):110-116. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-23-110-116

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ISSN 2079-701X (Print)
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