Vagotonia: what is it and how does the disease manifest? Treatment of vagotonia

Vagotonia is a pathological condition of the body, provoked by excessive tone of the vagus nerve, which is responsible for the normal functional functioning of internal organs, the process of secretion and the functioning of blood vessels.
This disease is not independent, and the symptoms of vagotonia manifest themselves in dozens of clinical indicators, which greatly complicates diagnosis.

The identical name for vagotonia is parasympathicotonia, or VSD of the vagotonic type. The pathological condition is quite common in children and adolescence.

According to statistics, more than fifty percent of children who are brought to the pediatrician with non-infectious diseases have vagotonia.

Diagnosis of autonomic dysfunction of this type in adults also occurs quite often, when the main factor in the appearance of vagotonia is a sedentary lifestyle, poor nutrition, more stress and heavy physical and psycho-emotional stress in everyday life and at work.

Diagnosis of the disease always occurs using a differential method. Doctors will rule out structural organ damage, according to the patient’s complaints. If hardware tests are normal, but there are further complaints, vagotonia is diagnosed.

A broader concept that includes vagotonia is vegetative-vascular dystonia (vegetative dystonia syndrome, VSD). The concept of vagotonia is a special case, one of the subtypes of VSD. Often the diagnosis may be recorded as autonomic dysfunction of the vagotonic type.

Making such a diagnosis suggests that the dystonia factor is a spasm of the vagus (vagus nerve).

Hypertonicity of the vagus nerve is the cause of vagotonia

What is vagotonia

Autonomic dysfunction is a complex of various pathological reactions of the body, which develops as a result of any deviations in the activity of the autonomic nervous system.

Vagotonia in adults is one of the forms of vegetative-vascular dystonia, resulting from increased tone of the vagus nerve. Another type of autonomic dysfunction is expressed in the predominance of the functionality of the sympathetic nervous system.

The vagus nerve is located in the neck and goes from the brain to the organs, thus being responsible for their functioning. Due to the development of vagotonia, the normal proper functioning of internal organs and blood vessels is disrupted, which negatively affects the human condition.

The vagotonic type of autonomic dysfunction is widespread in childhood and adolescence, since they have a growing body, hormonal changes in the body and a fragile, immature nervous system. However, a large percentage of those suffering from vagotonia are also found among the adult population.

The complex rhythm and lifestyle increasingly exposes people to stress and increased emotional stress, which not everyone can cope with.

Prevention

For the treatment and prevention of vagotonia, you should follow a list of actions that will help maintain the normal state of the autonomic nervous system:

• Stick to a daily routine, setting aside time for proper rest and sleep for at least ten hours;
• Allocate at least one hour a day for walking;
• Exercise. Swimming, gymnastics, dancing, athletics, and walking are recommended. Restrictions for athletes with heavy sports;
• Eliminate or minimize psycho-emotional stress;
• Eliminate alcoholic drinks, cigarettes, drugs;
• Proper nutrition. It is necessary to saturate the diet with plenty of vitamins and minerals. Reduce consumption of fatty, fried, spicy and salty foods;
• Maintain water balance by drinking at least 1.5 liters of clean water per day;
• Once a year, undergo a routine examination for early diagnosis of possible diseases.

Causes and factors contributing to the occurrence of vagotonia in adults

A specific cause causing the state of vagotonia has not been identified. First of all, there are several unfavorable factors that simultaneously affect the body and cause the patient’s painful condition.

In medical practice, the following factors contributing to the development of vagotonia are considered:

• traumatic brain injuries, including concussion;
• intracranial pressure;
• cervical spine injuries;
• prolonged emotional stress conditions;
• impaired functioning of the digestive and respiratory systems;
• presence of chronic diseases;
• diabetes;
• lack of physical activity;
• sudden change in climatic conditions;
• genetic predisposition;
• congenital tendency in case of damage to the nervous system during its prenatal formation;
• the period of menopause in women as a result of hormonal changes.

Causes of the disease

It is believed that vagotonic disorders constitute a whole complex of causes, of which it is difficult to identify the main ones. However, there are factors that increase the likelihood of developing the disease. First of all, we are talking about age.

The disease primarily affects children and adolescents.

Moreover, girls are at higher risk compared to boys. This is due to the fact that during the growth process the body is still immature, as well as hormonal changes and rapid growth. Having fallen ill at this age, by the age of forty a person receives a clearly defined impairment of health.

It is believed that this disease is very common throughout the planet. Scientists suggest that signs of vagotonia are present in more than half of the world's population.

Hereditary predisposition to the disease also plays an important role.

Along with the above, there are also specific reasons that can lead to vagotonia.

1. Severe head injuries can trigger the disease. Concussion is also worth mentioning here.
2. Some birth injuries (in particular, birth hypoxia) are dangerous in this regard.
3. If intracranial pressure is too high, this may become a risk factor.
4. Various stressful situations. Here we are talking not only about emotional, but also about any other overload (physical overload, hypothermia, and the like).
5. If the respiratory or digestive system is not functioning well.
6. Lack of physical activity (hypodynamia).
7. Infectious diseases are very dangerous, especially long-term foci of infection.
8. Various metabolic disorders. An example is diabetes.
9. Moving between different climate zones.
10. Age. We talked above about the increased susceptibility of children to this disease. To this we can add the time when menopausal changes in the body occur.

Of course, these reasons do not lead to the disease with one hundred percent probability, but they significantly increase its likelihood.

Symptoms of vagotonia

Vagotonia is a pathological condition that negatively affects internal organs. Since vagotonia can affect different systems of the body, the patient may have problems with breathing, heart problems, loss of strength, nervousness, and sleep disturbances.

Symptoms of changes in respiratory function:

• the appearance of shortness of breath;
• suffocating attacks;
• weak breathing;
• bouts of dry, painful cough.

Symptoms of vagotonia, indicating dysfunction of the digestive organs:

• decreased appetite;
• the appearance of belching, heartburn;
• frequent attacks of nausea;
• difficulty in swallowing;
• rumbling in the abdomen;
• diarrhea;
• pain in the chest and abdomen.

Signs of problems with brain function:

• regular headache;
• tendency to panic attacks, apathy and depression;
• insomnia;
• lack of concentration;
• weakness.

Symptoms of vagotonia associated with the functioning of the cardiovascular system:

• lowering blood pressure;
• slow heart rate;
• feeling of constriction in the chest area.

Symptoms of vagotonia can manifest themselves in different ways: they can be complex, appear suddenly, or have mild symptoms. The disease can develop and occur in a latent form.

Important! Vagotonia in adults is not an independent disease, therefore similar overlapping symptoms appear in many clinical diseases, which significantly complicates diagnosis and diagnosis.

Diagnostics

Doctors themselves call VSD of the vagotonic type a diagnosis of exclusion. That is, a patient who comes to the clinic is fully examined for various diseases. However, none of the pathologies are clearly identified. In this case, doctors diagnose “VSD of the vagotonic type.” During diagnosis, the patient undergoes a number of studies depending on the primary complaints:

1. Cardiac signs. The heart is examined using ECG (electrocardiography) and ultrasound (echocardiography).
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2. Gastrointestinal symptoms. Ultrasound of the gastrointestinal tract.
3. Brain disorders. CT or MRI of the brain.
4. Respiratory signs. X-ray of the chest organs.

In addition, the patient undergoes a general and biochemical blood test, a general urine test and stool test for coprogram.

Complications

Autonomic dysfunction is not a harmless condition of the body - periodic attacks have an adverse effect on the functioning of many organs and, without proper attention, can lead to the development of complications, such as:

• ischemic stroke;
• hypertension;
• bronchial asthma;
• stomach ulcer;
• mental disorder.

Without proper treatment, vagotonia can become chronic, in which the symptoms are constant or exacerbations (crises) occur with a sharp deterioration in well-being.

Symptoms

Signs of vagotonia may be as follows:

• Sweating.
• The skin becomes cold and damp.
• Bradycardia occurs (a type of arrhythmia in which the heart rate becomes less than 60 beats per minute).
• There is a tendency to faint.
• Hypersalivation (increased secretion of the salivary glands).
• Respiratory arrhythmia.
• Patients become slow, indecisive, phlegmatic, have little endurance, and are prone to depression.

• Problems with the digestive system: diarrhea or, conversely, constipation, abdominal pain, swelling under the eyes, allergic reactions of various origins.
• The patient may experience constriction of the pupils.
• Obesity.
• Poor tolerance to cold.
• Strengthening erection.

Ways to combat vagotonia

Only a doctor can establish a diagnosis and select the correct treatment complex.

The treatment course is selected individually, taking into account the patient’s age category, his complaints and the presence of concomitant diseases.

Treatment of vagotonia in adults requires an integrated approach using drug therapy and other techniques.

It is necessary to consult several specialists - a neurologist, endocrinologist, psychiatrist and therapist. In many cases, individual conversations with a psychologist are required.

A mild form of autonomic disorder usually does not require medication. In this case, simple preventive measures can help, such as proper nutrition, sleep patterns, rest, moderate physical activity, and eliminating sources of stress.

In addition, in the absence of contraindications, physiotherapeutic procedures are useful - electrophoresis, infrared laser therapy and other courses.

Physiotherapy is aimed at relieving muscle tension, improving blood circulation and lymph outflow.

Also, daily walks in the fresh air, light exercises, visiting the pool, massage and other relaxing procedures have a beneficial effect on relieving the symptoms of vagotonia.

Drug therapy is prescribed for adults with severe manifestations of the disease. As a rule, they are prescribed:

• sedatives for the nervous system;
• antidepressants;
• restorative drugs;
• vitamin complexes, herbal medicines;
• preparations with magnesium and potassium.

The course of administration and type of medication should be prescribed only by the attending physician.

Folk remedies

Traditional medicine has proven itself well in the treatment of vagotonia: herbal infusions and tea with herbs have a beneficial calming effect on the body:

• Hawthorn fruits will help strengthen the heart muscle and improve blood circulation;
• Using ginseng tincture will help calm the nervous system, improve metabolic processes, boost the immune system and reduce the symptoms of vagotonia;
• Motherwort, St. John's wort, and thyme will help improve sleep, reduce excitability and normalize the emotional state;
• Reduce headaches; mint is good as a pain reliever and sedative.

Cardiopsychoneurosis

Neurocirculatory dystonia (NCD)

– a complex of disorders of the cardiovascular system of a functional nature, developing as a result of disorders of neuroendocrine regulation.

Neurocirculatory dystonia has a polyetiological genesis, is accompanied by many different, mainly cardiovascular, manifestations that arise or worsen under the influence of stress, and is characterized by a benign course and a satisfactory prognosis.

Neurocirculatory dystonia in the literature is sometimes referred to as “heart neurosis”, “neurocirculatory asthenia”, “excitable heart”.

It is customary to distinguish between two types of functional disorders of the cardiovascular system: vegetative-vascular and neurocirculatory dystonia.

Vegetative-vascular dystonia combines various manifestations of autonomic dysfunction that accompany organic lesions of the nervous, endocrine and other systems.

Neurocirculatory dystonia is an independent nosological form with its own etiology, pathogenesis, symptoms and prognosis and differs in a number of features from autonomic dysfunction.

Distinctive features of neurocirculatory dystonia are the predominance of cardiovascular symptoms among clinical manifestations, the primary functional nature of disorders of autonomic regulation and the lack of connection with organic pathology, including neurosis.

Neurologists, cardiologists, and general practitioners quite often have to deal with neurocirculatory dystonia. Among cardiological and therapeutic patients, NCD occurs in 30-50% of individuals.

Neurocirculatory dysfunction can develop at different ages, but is more common in young people, mainly women, who suffer from it 2-3 times more often than men.

The disease rarely develops in persons younger than 15 and older than 40-45 years.

Cardiopsychoneurosis

Various factors can lead to the development of neurocirculatory disorders, but they do not include organic damage to the endocrine and nervous systems.

In adolescence and youth, neurocirculatory dystonia is usually caused by imperfections in the neuroendocrine mechanism for regulating autonomic processes.

The development of NCD in the prepubertal and pubertal periods is facilitated by increased mental and physical stress and the social environment.

In people of any age, neurocirculatory dystonia can develop against the background of acute and chronic infections, lack of sleep, overwork, mental trauma, exposure to physical and chemical factors (insolation, hot climate, vibration), poor diet, physical activity (overload or physical inactivity), intoxication, including alcohol and tobacco. Periods of hormonal changes in the body (puberty, abortion, pregnancy, menopause, ovarian dysfunction) play a role in the development of neurocirculatory dystonia.

A number of patients have a hereditary constitutional predisposition to the development of neurocirculatory dystonia.

The impact of these factors causes dysfunction of the neurohumoral control of the cardiovascular system, where the leading pathogenetic link is damage to the hypothalamic-pituitary structures that coordinate these processes.

Violation of neurohumoral control is manifested by a disorder of the functions of systems that ensure homeostasis processes in the body: cholinergic, sympathetic-adrenal, kallikreinin, histamine-serotonin, etc.

This, in turn, triggers mechanisms leading to disruption and multiple changes in carbohydrate, water-electrolyte metabolism, acid-base status, mediator and hormonal systems.

In myocardial tissues, biologically active substances (histamine, serotonin, kinins, etc.) are activated, causing metabolic disorders and the development of dystrophy.

On the part of the circulatory system, fluctuations in vascular tone, spasms of peripheral vessels, and slowing of microcirculation are observed, which leads to the development of tissue hypoxia.

Once formed, the pathogenetic mechanisms become autonomous, and neurocirculatory dystonia becomes an independent disease. Any irritants (changes in weather conditions, stress, etc.) cause a pathological reaction, causing the manifestation of one or another type of neurocirculatory dystonia.

According to etiological forms, essential (constitutional-hereditary), psychogenic (neurotic), infectious-toxic, dishormonal, mixed neurocirculatory dystonia, as well as NCD of physical overexertion are distinguished.

Depending on the leading clinical syndrome according to the classification of V.P. Nikitin (1962) and N.N.

Savitsky (1964) distinguishes four types of neurocirculatory dystonia: cardiac (with a predominant disorder of cardiac activity), hypotensive (with a predominant decrease in blood pressure), hypertensive (with a predominant increase in blood pressure), mixed (combines disorders of blood pressure and cardiac activity). Based on the severity of symptoms, mild, moderate and severe degrees of neurocirculatory dystonia are distinguished; according to the variant of the course - phases of exacerbation and remission.

A common manifestation for all types of neurocirculatory dystonia is a neurosis-like state, characterized by fatigue, weakness, sleep disturbance, irritability, decreased memory, mood and volitional qualities, deterioration in concentration, which is accompanied by functional circulatory disorders of a predominant nature.

Cardiac type

The course of the cardiac type of neurocirculatory dystonia is manifested by cardialgia, palpitations, interruptions in heart function, and sometimes shortness of breath during physical activity; no significant changes in blood pressure are observed.

Objectively, tachycardia, respiratory arrhythmia, paroxysms of tachycardia, supraventricular extrasystoles, changes in cardiac output inadequate to the load can be determined, and on the ECG - a change in the voltage of the T wave (high or reduced).

Hypotensive type

Neurocirculatory dystonia of the hypotensive type is characterized by symptoms of chronic vascular insufficiency: a decrease in systolic blood pressure less than 100 mm Hg. Art.

, chilliness of the feet and hands, a tendency to orthostatic collapse and fainting. Also, for patients with the hypotensive type of NCD, complaints of fatigue, muscle weakness, and headaches are typical.

Such patients, as a rule, have an asthenic physique, pale skin, and cold and damp palms.

Hypertensive type

The hypertensive type of neurocirculatory dystonia is characterized by a transient increase in blood pressure to 130-140/85-90 mmHg. Art.

, which in half of the cases is not accompanied by a subjective change in the patients’ well-being and is detected during medical examinations. Complaints of palpitations, headaches, and fatigue are less common.

The hypertensive type of NCD in its characteristics coincides with borderline arterial hypertension.

NDC degrees

A mild degree of neurocirculatory dystonia is characterized by moderately severe symptoms that arise only in connection with psycho-emotional overload. The patients' ability to work is preserved; a slight decrease in physical endurance may be observed; drug therapy is not indicated.

With neurocirculatory dystonia of moderate severity, there is a multiplicity of symptoms and a decrease in physical performance by more than 50%.

Decreased or temporary loss of ability to work requires medication therapy.

With severe manifestations of neurocirculatory dystonia, persistent and multiple clinical symptoms are observed, a sharp decrease or loss of ability to work, requiring hospital treatment of patients.

The low specificity of the symptoms of neurocirculatory dystonia makes diagnosis difficult and requires careful verification of the diagnosis.

Confirming diagnostic criteria for neurocirculatory dystonia based on patient complaints can be symptoms that can be observed for 1-2 months: cardialgia, palpitations, feeling of lack of air, pulsation in the precordial area or in the area of ​​the neck vessels, weakness, increased fatigue, neurotic manifestations (irritability, anxiety , sleep disturbance), dizziness, cold and wet extremities. Neurocirculatory dystonia is characterized by a multiplicity of complaints that have a clear connection with stressful situations or periods of hormonal changes, the course of the disease with periods of remissions and exacerbations, but without a tendency to progress.

Reliable physical criteria for the presence of NCD include an unstable heart rhythm with a tendency to tachycardia that appears spontaneously or inappropriately to the situation, lability of blood pressure, the presence of respiratory arrhythmias (tachypnea, dyspnea), hyperalgesia in the cardiac region. On the ECG, patients may register tachycardia, arrhythmia, migration of the pacemaker (21.3%), extrasystole (8.8%), paroxysmal tachycardia and atrial fibrillation (3%), negative T waves in two or more leads (39.4 %).

Diagnostic ECG tests with stress are informative diagnostic methods for neurocirculatory dystonia.

• A physiological test with hyperventilation involves performing forced inhalations and exhalations for 30-40 minutes, followed by recording an ECG and comparing it with the original one. A positive test indicating NCD is an increase in heart rate by 50-100% and the appearance of negative T waves on the ECG or an increase in their amplitude.
• An orthostatic test involves recording an ECG in a lying position, and then after standing for 10-15 minutes. Positive results of the test are the same changes as with the test with hyperventilation, observed with NCD in 52% of patients.
• Drug tests (with β-blockers, potassium) are aimed at distinguishing between neurocirculatory dystonia and organic heart diseases. ECG registration is carried out 40-60 minutes after taking 60-80 mg of β-blockers (obsidan, inderal, anaprilin) ​​or 6 g of potassium chloride. In case of organic cardiopathologies (myocarditis, ischemic heart disease, myocardial hypertrophy), a positive T wave is recorded; in case of NCD, a negative T wave is recorded.

When performing bicycle ergometry, a decrease in exercise tolerance typical of neurocirculatory dystonia is determined, i.e.

a patient with neurocirculatory dystonia is able to perform less workload than a healthy person of the same age and gender.

Laboratory data indicate an increase in the activity of the sympathetic-adrenal system: in response to the load in the blood, an inadequate increase in the level of norepinephrine, adrenaline, metabolites, and lactic acid is observed.

In the treatment of neurocirculatory dystonia, an extremely important place is occupied by non-drug measures designed to increase the body's adaptive capabilities to changing conditions. For NCD, hardening procedures, sports activities (athletics, swimming), rational psychotherapy, and normalization of work and rest regimes are indicated.

Balneotherapy, physiotherapy (therapeutic showers and baths, electrosleep, reflexology, electrophoresis with bromine, magnesium, novocaine), exercise therapy, and spa treatment have a positive effect on training the system of regulation of autonomic functions. For sleep disturbances and irritability, it is possible to prescribe sedatives: motherwort, valerian, tranquilizers (oxazepam, etc.).

For the treatment of neurocirculatory dystonia of the cardiac and hypertensive type, the use of β-blockers (atenolol, propranolol, oxprenolol), which eliminate tachycardia, hypertension, cardialgia, as well as drugs that improve the metabolism of the heart muscle (inosine, potassium preparations, B vitamins), is indicated. For neurocirculatory dystonia of the hypotensive type with the presence of asthenia and orthostatic disorders, tincture of ginseng (schizandra, aralia) and caffeine are prescribed.

The course of any type of neurocirculatory dystonia does not cause the development of cardiomegaly, heart failure or life-threatening rhythm and conduction disturbances.

In adolescence, with timely treatment or self-healing, complete recovery occurs. With age, the prognosis for complete recovery of neurocirculatory dystonia decreases.

A decrease or temporary loss of ability to work can be observed during periods of exacerbation.

Patients with the hypertensive type of neurocirculatory dystonia are at risk for hypertension; with any type of NCD due to lipid metabolism disorders, the likelihood of developing atherosclerosis and ischemic heart disease cannot be excluded.

Issues of preventing neurocirculatory dystonia go beyond purely medical measures. Prevention includes proper physical, mental and hygienic education of adolescents, increasing their self-esteem and social adaptation. The role of promoting a healthy lifestyle, playing sports, avoiding smoking and drinking alcohol is great.

Medical prevention of neurocirculatory dystonia includes the fight against focal infections, stress factors, and regulation of hormonal levels in women during menopause.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_cardiology/cardiopsychoneurosis