[Psychosomatic reactions comorbid with ischemic heart disease: psychogenically provoked infarctions and myocardial...

Ischemic heart disease (IHD) with psychogenic provoked myocardial infarctions (MI) and myocardial ischemic disease (MID) is considered as a psychosomatic disorder. Seventy patients, 17 female and 53 male, aged between 39-77 years, mean age 61.2 +/- 9.9 years, were observed. The presence of both somatic (prolonged atherosclerotic lesion of coronary arteries) and mental (personality disorders with symptoms of reactive lability under psychic trauma influence) predisposition is obligate for manifestation or exacerbation of this IHD type. It is suggested that atherosclerotic coronary vessels affection of heterogeneity may exist. Two types of vulnerability are described. In type 1 cardiovascular system exhibits selective sensitivity to the influence of obligate and of great personality significance cathatymic affect. A strict condition of its realization is amplification of negative emotions up to a level of pathological affective outbursts in the spectrum of paranoiac or explosive reactions. In these cases, IHD is characterized by a stable course (angina of high tensions, without instable anginal episodes etc). In type 2 cardiovascular system reveals vulnerability to negative emotions, the continuum of which is ended by polar pathological affects-cathatymic and anxiety. In contrast to cathatymic affect, a common feature of anxiety affect is a fast, like short-term emotional outburst, manifestation of instable, labile, dramatic external appearances (with tears, converse disorders etc). IHD symptom complex is distinguished by pronounced clinical manifestations (stenocardia of tension with progressive impairment of tolerability to loadings).