A reclined position and forced bed rest were the most beneficial.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. Pharmacological intervention came in the form of digitalis, a group of glycoside drugs derived from the foxglove (Digitalis purpurea), which is now known to act as a sodium-potassium ATPase inhibitor, increasing stroke volume and decreasing heart rate; at the time it was used for the latter effect in patients with palpitations. History
Da Costas syndrome is named for the surgeon Jacob Mendes Da Costa, who first observed it in soldiers during the American Civil War. At the time it was proposed, Da Costas syndrome was seen as a very desirable physiological explanation for "soldiers heart". Use of the term "Da Costas syndrome" peaked in the early 20th century. Towards the mid-century, the condition was generally re-characterized as a form of neurosis. It was initially classified as "F45.3" (under somatoform disorder of the heart and cardiovascular system) in ICD-10, and is now classified under "somatoform autonomic dysfunction". Da Costas syndrome involves a set of symptoms which include left-sided chest pains, palpitations, breathlessness, and fatigue in response to exertion.
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


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