Soldier’s heart: the forgotten circulatory neurasthenia – a systematic review

Borges, Guilherme Passamani; Tonon, João Henrique Almeida; Zunini, Pablo Andres Alves da Silva; Martins-da-Silva, Anderson Sousa; Garcia, Marcelo de Freitas Valeiro; Périco, Cíntia de Azevedo-Marques; Lima, Danielle Ruiz; Torales, Júlio; Ventriglio, Antonio; Bhugra, Dinesh; Castaldelli-Maia, João Maurício

doi:10.1080/09540261.2020.1757925

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…But also after the Second World War, when psychosomatic theories emerged and connections were made between living conditions, stress, and physical illnesses (Bastiaans, 1957; Weiss & English, 1943). The discussion between soma and psyche continues to this day, for example, with the concepts of “blast trauma” and brain injury (Greer et al, 2018) resembling the earlier “shell shock” discussions or with the recently re-cited old concept of the “soldier’s heart” and cardiological phenomena (Borges et al, 2020).…”

Section: Discussion and Challenges For The Futurementioning

confidence: 99%

Unity or Anarchy? A Historical Search for the Psychological Consequences of Psychotrauma

Jongedijk

Boelen

Knipscheer

et al. 2023

Review of General Psychology

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The field of traumatic stress is often referred to as being in a state of controversy and lack of continuity. Throughout history, disputes repeatedly centered on defining the psychological consequences of severe adverse events and on their causes. Even to this day this is current. To understand these controversies, an extensive historical literature review is presented of how mental consequences of trauma have been described in history, of the circumstances in which this took place, and of the disputes that have influenced the conceptualization of these mental responses. We found psychotrauma always being surrounded by controversy. Significant heterogeneity in symptom expression has been described over the centuries to this day. Some symptoms appeared steadily over many decades, but often each time period showed its own core symptoms. At syndrome level, we found an acute condition, one with longer duration, and a complex condition. Also here, definitions varied over the decades. Finally, causes have always been debated, such as biological, psychological, socio-economic, cultural, political, or legal. To better reflect the described ongoing variation in symptomatology, a more flexible diagnostic approach is proposed with a combination of both staging and subtyping that offers room for a more flexible, symptom-oriented, and personalized perspective.

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Section: Discussion and Challenges For The Futurementioning

confidence: 99%

Unity or Anarchy? A Historical Search for the Psychological Consequences of Psychotrauma

Jongedijk

Boelen

Knipscheer

et al. 2023

Review of General Psychology

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“…Although psychological symptoms are common in POTS they usually are not causal (Masuki et al, 2007a ). Nevertheless, heart and circulatory neurasthenia and soldier's heart continue to be considered as post-traumatic stress disorder by some (Dyde, 2011 ; Borges et al, 2020 ). Signs and symptoms of POTS resemble extreme deconditioning as observed following prolonged bed rest or spaceflight (Vernikos and Convertino, 1994 ; Levine et al, 1997 ; Gisolf et al, 2005 ; Joyner and Masuki, 2008 ) and most subjects suffering from this condition benefit from exercise training (Harms and van Lieshout, 2001 ; Shibata et al, 2012 ).…”

Section: Postural Stress and Exercisementioning

confidence: 99%

Central Hypovolemia Detection During Environmental Stress—A Role for Artificial Intelligence?

2021

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The first step to exercise is preceded by the required assumption of the upright body position, which itself involves physical activity. The gravitational displacement of blood from the chest to the lower parts of the body elicits a fall in central blood volume (CBV), which corresponds to the fraction of thoracic blood volume directly available to the left ventricle. The reduction in CBV and stroke volume (SV) in response to postural stress, post-exercise, or to blood loss results in reduced left ventricular filling, which may manifest as orthostatic intolerance. When termination of exercise removes the leg muscle pump function, CBV is no longer maintained. The resulting imbalance between a reduced cardiac output (CO) and a still enhanced peripheral vascular conductance may provoke post-exercise hypotension (PEH). Instruments that quantify CBV are not readily available and to express which magnitude of the CBV in a healthy subject should remains difficult. In the physiological laboratory, the CBV can be modified by making use of postural stressors, such as lower body “negative” or sub-atmospheric pressure (LBNP) or passive head-up tilt (HUT), while quantifying relevant biomedical parameters of blood flow and oxygenation. Several approaches, such as wearable sensors and advanced machine-learning techniques, have been followed in an attempt to improve methodologies for better prediction of outcomes and to guide treatment in civil patients and on the battlefield. In the recent decade, efforts have been made to develop algorithms and apply artificial intelligence (AI) in the field of hemodynamic monitoring. Advances in quantifying and monitoring CBV during environmental stress from exercise to hemorrhage and understanding the analogy between postural stress and central hypovolemia during anesthesia offer great relevance for healthy subjects and clinical populations.

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“…The extreme mental stress of military combat—the anticipation of a violent death in the immediate future—and its pathological impact on the heart, was first formally noted by Jacob Da Costa ( 9 ). The term Soldier's Heart , ultimately known as Da Costa's Syndrome, included palpitation, fatigue, breathlessness, chest pain, sighing, dizziness, and faintness ( 10 ). This constellation of physical symptomatology, at least contemporaneous with severe mental stress, is clearly indicative of significant cardiac distress, though there is no evidence either that it was protracted or that it gave rise to an elevated risk of clinically documented, acute cardiac events such as myocardial infarction.…”

mentioning

confidence: 99%