Da Costas syndrome (also known as "soldiers heart", cardiac neurosis, chronic asthenia, effort syndrome, functional cardiovascular disease, neurocirculatory asthenia, primary neurasthenia, subacute asthenia and irritable heart) is a psychiatric syndrome which presents a set of symptoms similar to those of heart disease. These include fatigue upon exertion, shortness of breath, palpitations, sweating, and chest pain. While a physical examination does not reveal any gross physiological abnormalities, orthostatic intolerance has been noted. It was originally thought to be a cardiac condition, and treated with a predecessor to modern cardiac drugs. While the condition was eventually recategorized as psychiatric, in modern times, it is known to represent several disorders, some of which now have a known medical basis. For stress-related combat disorders generally, see post-traumatic stress disorder. Historically, similar forms of this disorder have been noticed in various wars, like the American Civil War and Crimean war, and among British troops who colonized India. The condition was named after Jacob Mendes Da Costa who investigated and described the disorder in 1871. Signs and symptoms
Symptoms of Da Costas syndrome include fatigue upon exertion, weakness induced by minor activity, shortness of breath, palpitations, sweating, and chest pain. Causes
Da Costas syndrome was originally considered to be heart failure or other cardiac condition, and was later recategorized to be psychiatric. The term is no longer in common use by any medical agencies and has generally been superseded by more specific diagnoses, some of which have a medical basis.
In 1876 surgeon Arthur Davy attributed the symptoms to military foot drill where “over-expanding the chest, caused dilatation of the heart, and so induced irritability".During World War I, Sir Thomas Lewis (who had been a member of staff of the Medical Research Committee) studied many soldiers who had been referred to the Military Heart Hospitals in Hampstead and Colchester with disordered action of the heart or valvular disease of the heart. In 1918 he published a monograph summarizing his findings, which showed that the vast majority did not have structural heart disease, as evidenced by the diagnostic methods available at the time. In it, he reviewed the difference in symptoms between effort syndrome and structural heart disease, examined possible causes of effort syndrome, the diagnosis of structural heart disease in soldiers, its outlook and treatment, and lessons learned by the Army. Since then, a variety of similar or partly similar conditions named above have been described. See also
Shell shock
Combat fatigue
Takotsubo cardiomyopathy
Postural orthostatic tachycardia syndrome
Soldiers Heart (novel)

References


== External links ==