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Neurocirculatory asthenia(ORSTI)

MedGen UID:
283928
•Concept ID:
C1535893
•
Finding
Synonyms: Irritable heart; Mitral valve prolapse syndrome; Norepinephrine Transporter Deficiency; ORSTI; Orthostatic intolerance; Soldiers heart
SNOMED CT: Orthostatic intolerance (870368003)
 
Gene (location): SLC6A2 (16q12.2)
 
Monarch Initiative: MONDO:0001315
OMIM®: 604715

Definition

A condition characterized by development of symptoms while standing. It is an autonomic nervous system disorder and the symptoms are relieved once the person sits back down. Symptoms include heart palpitations, sweating, anxiety, lightheadedness, hyperpnea, anxiety, and blurred vision. [from NCI]

Clinical features

From HPO
Elevated urinary norepinephrine level
MedGen UID:
1841548
•Concept ID:
C5826344
•
Finding
The concentration of noradrenaline in the urine, normalized for urine concentration, is above the upper limit of normal.
See: Feature record | Search on this feature
Orthostatic tachycardia
MedGen UID:
866749
•Concept ID:
C4021099
•
Finding
An increase in heart rate with standing of 30 beats per minute or more.
See: Feature record | Search on this feature
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Professional guidelines

PubMed

Neurocirculatory asthenia: a reassessment using modern psychosomatic criteria.
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Propranolol in the treatment of neurocirculatory asthenia--an open pilot study.
Rimón R, Kampman R, Viukari M
Isr Ann Psychiatr Relat Discip 1979 Jun;17(2):144-8. PMID: 291588
Diagnosis and treatment of NCA.
OHSUZU H
Jpn Circ J 1963 Feb;27:206-9. doi: 10.1253/jcj.27.206. PMID: 13939695

Recent clinical studies

Etiology

Pressure Pain Sensitivity: Marker for Stress Affecting General Health.
Vaněček V, Tuček M, Ballegaard S
Cent Eur J Public Health 2017 Mar;25(1):64-66. doi: 10.21101/cejph.a4931. PMID: 28399357
Life events and neurocirculatory asthenia. A controlled study.
Sonino N, Fava GA, Boscaro M, Fallo F
J Intern Med 1998 Dec;244(6):523-8. PMID: 9893106
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Neurocirculatory asthenia: a reassessment using modern psychosomatic criteria.
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Increased cardiac awareness in panic disorder.
Ehlers A, Breuer P
J Abnorm Psychol 1992 Aug;101(3):371-82. doi: 10.1037//0021-843x.101.3.371. PMID: 1500594

Diagnosis

On chronic fatigue syndrome and nosological categories.
Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y
Clin Rheumatol 2018 May;37(5):1161-1170. Epub 2018 Feb 7 doi: 10.1007/s10067-018-4009-2. PMID: 29417255
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Cardiac neurosis and psychopathology.
Conti S, Savron G, Bartolucci G, Grandi S, Magelli C, Semprini F, Saviotti FM, Trombini G, Fava GA, Magnani B
Psychother Psychosom 1989;52(1-3):88-91. doi: 10.1159/000288304. PMID: 2486407
Hyperventilation syndrome: a review.
Morgan WP
Am Ind Hyg Assoc J 1983 Sep;44(9):685-9. doi: 10.1080/15298668391405562. PMID: 6356858
MANAGEMENT OF NEUROCIRCULATORY ASTHENIA.
ADSETT CA, ROSS WD
Biochem Clin 1963;2:299-308. PMID: 14095780

Therapy

Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis.
Fogari R, Zoppi A, Corradi L, Pasotti C, Malamani GD, Gradnik R, Bokor D, Gala C
Cardiovasc Drugs Ther 1992 Jun;6(3):249-53. doi: 10.1007/BF00051146. PMID: 1353368
Bromism: rare but still present.
Pelckmans MC, Verdickt W, Verberckmoes R, Van Boven M, Lissens W, Schurmans P, Daenens P
Acta Clin Belg 1983;38(6):397-400. doi: 10.1080/22953337.1983.11718968. PMID: 6673440
Asthenia in cancer.
Theologides A
Am J Med 1982 Jul;73(1):1-3. doi: 10.1016/0002-9343(82)90910-x. PMID: 7091166
Nervous and behavioral effects of microwave radiation in humans.
Silverman C
Am J Epidemiol 1973 Apr;97(4):219-24. doi: 10.1093/oxfordjournals.aje.a121502. PMID: 4577165
Diagnosis and treatment of beta-adrenergic receptor hyperresponsiveness. A critical appraisal.
Bourne HR, Thomson PD, Melmon KL
Arch Intern Med 1970 Jun;125(6):1063-6. PMID: 4378135

Prognosis

Soldier's heart: the forgotten circulatory neurasthenia - a systematic review.
Borges GP, Tonon JHA, Zunini PAADS, Martins da Silva AS, Garcia MFV, de Azevedo-Marques Périco C, Lima DR, Torales J, Ventriglio A, Bhugra D, Castaldelli-Maia JM
Int Rev Psychiatry 2020 Aug-Sep;32(5-6):510-519. Epub 2020 May 27 doi: 10.1080/09540261.2020.1757925. PMID: 32459107
On chronic fatigue syndrome and nosological categories.
Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y
Clin Rheumatol 2018 May;37(5):1161-1170. Epub 2018 Feb 7 doi: 10.1007/s10067-018-4009-2. PMID: 29417255
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Neurocirculatory asthenia: a reassessment using modern psychosomatic criteria.
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Cardiac involvement in liver cirrhosis.
Gatta A, Merkel C, Sacerdoti D, Angeli P
Ann Ital Med Int 1993 Oct-Dec;8(4):244-7. PMID: 8161481

Clinical prediction guides

On chronic fatigue syndrome and nosological categories.
Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y
Clin Rheumatol 2018 May;37(5):1161-1170. Epub 2018 Feb 7 doi: 10.1007/s10067-018-4009-2. PMID: 29417255
The impact of depression and cardiophobia on quality of life in patients with essential hypertension.
Tsartsalis D, Dragioti E, Kontoangelos K, Pitsavos C, Sakkas P, Papadimitriou GN, Stefanadis C, Kallikazaros I
Psychiatriki 2016 Jul-Sep;27(3):192-203. doi: 10.22365/jpsych.2016.273.192. PMID: 27837573
Psychological aspects of non-cardiac chest pain.
Serlie AW, Erdman RA, Passchier J, Trijsburg RW, ten Cate FJ
Psychother Psychosom 1995;64(2):62-73. doi: 10.1159/000288993. PMID: 8559955
Neurocirculatory asthenia: a reassessment using modern psychosomatic criteria.
Fava GA, Magelli C, Savron G, Conti S, Bartolucci G, Grandi S, Semprini F, Saviotti FM, Belluardo P, Magnani B
Acta Psychiatr Scand 1994 May;89(5):314-9. doi: 10.1111/j.1600-0447.1994.tb01521.x. PMID: 8067269
Cardiac involvement in liver cirrhosis.
Gatta A, Merkel C, Sacerdoti D, Angeli P
Ann Ital Med Int 1993 Oct-Dec;8(4):244-7. PMID: 8161481

Recent systematic reviews

Soldier's heart: the forgotten circulatory neurasthenia - a systematic review.
Borges GP, Tonon JHA, Zunini PAADS, Martins da Silva AS, Garcia MFV, de Azevedo-Marques Périco C, Lima DR, Torales J, Ventriglio A, Bhugra D, Castaldelli-Maia JM
Int Rev Psychiatry 2020 Aug-Sep;32(5-6):510-519. Epub 2020 May 27 doi: 10.1080/09540261.2020.1757925. PMID: 32459107

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