Treatment of vegetative-vascular dystonia (VSD) in children and adults

Pain Treatment Center

Alekseeva

Oksana Alexandrovna

23 years of experience

Doctor, highest qualification category, member of the European Association of Neurologists, Russian Interregional Society for the Study of Pain (ROIB), Association of Interdisciplinary Medicine. Has experience working in hospital and outpatient services. He has seven published works on neurology.

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In ensuring the normal functioning of the human body, one of the key positions is occupied by the autonomic nervous system (ANS) - a complex of nervous structures responsible for maintaining a constant internal environment (homeostasis). The efforts of the ANS regulate the functioning of the circulatory and lymphatic systems, internal organs, and endocrine glands. The ANS itself is part of the nervous system (NS), but has an important feature - autonomy, that is, a person cannot control it with his own will.

Various disorders in the functioning of the ANS are called vegetative-vascular dystonia (VSD). This term does not mean a separate disease itself, but a syndrome - a condition caused by diseases of certain organs and systems (mental or somatic pathologies, hormonal imbalances).

Main symptoms and signs

The manifestations of VSD are diverse; the general list includes over several dozen items, but patients experience only a few of them (usually from 5 to 20) in different combinations. An important point: with VSD, there is a combination of several symptoms that appear simultaneously, but in the complete absence of organic disorders. A separate manifestation of any of these signs is not a reason for diagnosing vegetative-vascular dystonia, since it usually indicates a specific pathology.

Doctors distinguish several forms of VSD, classifying them on the basis of identifying relatively typical sets of symptoms that resemble the course of certain pathologies of organs or systems.

Respiratory form of VSD

Respiratory vegetative-vascular dystonia is the most common. The patient complains of the inability to take a deep breath, is afraid of suffocating, gasps for air, feels soreness, tightness in the throat, heaviness or pain in the chest, and coughs frequently.

Tachycardial form

Complaints of rapid heartbeat (tachycardia), irregular heart rhythm, sensation of vascular pulsation and heat in the temples and neck. It should not be confused with a similar picture with arrhythmia, paroxysmal tachycardia.

Cardiological form

In the area of ​​the heart, pain of a different nature is noted (long-term aching or sharp, sharp), without a clear localization. During an attack of cardiac vegetative-vascular dystonia, the patient is anxious and breathes heavily. The pain lasts longer than with cardiovascular diseases (angina pectoris, myocardial infarction), does not depend on physical activity and is not relieved by appropriate medications (validol, nitroglycerin and others).

Hypotonic form

Characterized by dizziness, darkening of the eyes, sudden perspiration on the forehead, sweating, weakness, cold palms. Blood pressure drops briefly to 90/60 or below.

Hypertensive form

During an attack, tachycardia and heart pain are observed against the background of a short-term increase in blood pressure. The main difference from real hypertension: the pressure does not exceed 150/90.

Asthenic form

Performance decreases, complaints of fatigue, weakness, inability to concentrate, and sometimes body temperature rises slightly. Tremor (shaking in the hands) is possible, especially with the slightest physical exertion or a stressful situation. Irritability for no apparent reason or due to insignificant reasons, tearfulness.

Visceral form

Manifested by symptoms from the gastrointestinal tract (functioning disorder, nausea, diarrhea, vomiting, irritable bowel syndrome).

Mixed form

It combines certain signs characteristic of all the above forms of VSD, in arbitrary combinations.

Sometimes patients experience acute manifestations of symptoms, so-called attacks of dystonia or vegetative crises. An attack of VSD is characterized by sudden, spontaneous and rapid development, regardless of the circumstances. It can happen both during physical activity or a stressful situation, and at rest or sleep; alone or in a crowded place. Patients are afraid of suffocation, fear of death from respiratory or cardiac arrest, some feel feverish, others feel cold.

Separately, it is worth mentioning pre-syncope and fainting. They can have different origins; based on trigger mechanisms, they are distinguished:

• psycho-emotional - as a result of experiences, fear, reaction to the sight of blood;
• orthostatic - due to a sudden change in position, usually when abruptly getting up from a chair or bed;
• hypotonic – due to a sharp decrease in blood pressure.

Loss of consciousness is usually short-lived, lasting 1-3 minutes, the patient quickly comes to his senses. A history of fainting may indicate more severe pathologies, such as adrenal or cardiovascular insufficiency, nephropathy, or diabetes mellitus.

With such an impressive range of complaints, patients often do not experience any pathological changes in the structure or functioning of organs and systems. They often experience fear of developing a serious pathology, attributing to themselves some kind of disease based on similar signs. So, some fear paralysis due to mild numbness of the limbs or a heart attack due to chest pain.

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Types and symptoms of VSD

In most cases, it is quite difficult to identify clearly distinguishable symptoms of vegetative-vascular dystonia. Many signs of this complex of syndromes may be indicators of the presence of diseases that are not directly related to VSD. Only a comparison of all indicators of the autonomic nervous system and/or brain in combination with cardiac or cardiovascular manifestations provides the basis for a definite medical conclusion. Before making a diagnosis of VSD, the doctor must understand the characteristics of the patient’s individual symptoms. Vegetative-vascular dystonia is usually divided into three types (based on blood pressure level):

• the hypertensive type is characterized by increased pressure (periodic surges), symptoms of vegetative-vascular dystonia of the hypertensive form may include increased sweating, anxiety, chills of the extremities, rapid heartbeat and visualized pulsation of large blood vessels (for example, carpal or popliteal);
• the hypotonic type is characterized by a decrease in blood pressure, in this case the symptoms of vegetative-vascular dystonia include shortness of breath, nausea, headache, general weakness, a tendency to faint, coldness of the toes and hands;
• the mixed type is characterized by periodic fluctuations in blood pressure (sometimes also called VSD of the cardiac form), here the symptoms of vegetative-vascular dystonia are usually considered to be general signs of fatigue, a feeling of lack of air, as well as interruptions in the functioning of the heart.

If you find yourself with the signs listed above, first of all, you should reconsider your work and rest schedule. Of course, consulting a doctor is also necessary.

Diagnostics

To begin with, the doctor, during a conversation with the patient, collects a detailed anamnesis - finds out the complaints, their nature, frequency of occurrence, the presence of a hereditary factor (are there people in the family who suffer from confirmed VSD).

Then a general examination is carried out, attention is paid to the patient’s behavior and his emotional background.

Due to the presence of symptoms similar to those of various other diseases (arrhythmia, hypertension, pathologies of the thyroid gland, gastritis, etc.), each patient with suspected VSD must undergo a detailed therapeutic examination in a clinical setting. To confirm the diagnosis of VSD, it is necessary to absolutely exclude diseases with similar symptoms. For this purpose, laboratory tests are prescribed:

• general blood analysis;
• general urine analysis;
• liver and kidney function indicators;
• analysis of thyroid hormone levels;
• clarifying tests at the discretion of the doctor.

Next, a referral is given for instrumental examinations, of which the most frequently used are:

• electrocardiography (ECG);
• echocardiography;
• 24-hour Holter blood pressure monitoring;
• fibrogastroduodenoscopy;
• Ultrasound of the abdominal organs, kidneys, neck vessels, thyroid gland;
• chest x-ray;
• spirometry;
• bicycle ergometry.

Sometimes the doctor requires additional diagnostic methods, such as computed tomography (CT), magnetic resonance imaging (MRI), electroencephalography, colonoscopy and others. Various functional tests are also carried out (psycho-emotional, orthostatic, physical exercise, pharmacological).

VSD of cardiac type

In the cardiological (as well as in the hypertensive) form of autonomic dysfunction, the diagnosis will most likely show obvious sympathicotonia, that is, functional tension in the work of the sympathetic department of the ANS. A distinctive feature of VSD of the cardiac type is pain in the heart area (stabbing, pressing or burning sensations in the chest area). Signs may resemble those of an angina attack or myocardial infarction. But upon examination, cardiac pathologies are not detected.

The cardiac type of reaction to a vegetative-vascular disorder is characterized by: tachycardia, cardiac arrhythmia, false pain in the heart area, as well as respiratory arrhythmia and asthma attacks. It is important to understand that with VSD, pain in the heart area is not a harbinger of a heart attack and does not in any way affect the cardiovascular system, which will be confirmed by the patient’s echocardiogram. Cardiac rhythmography is very effective in diagnosing this type of VSD.

Causes of occurrence and development

The etiology of VSD, as well as its symptoms, is extremely diverse. Among the main reasons, doctors name:

• pathological changes that occurred during pregnancy or childbirth (intrauterine hypoxia, infectious process, birth injuries, etc.);
• changes in hormonal levels (during puberty or during hormonal therapy);
• hereditary tendency (presence of autonomic disorders in close relatives);
• traumatic brain injuries of any severity;
• traumatic stressful situation, frequent psycho-emotional stress;
• high mental stress;
• excessive, or conversely, insufficient physical activity;
• toxic effects of certain substances;
• unbalanced, irregular nutrition;
• long-term course of chronic diseases (diabetes mellitus, hypertension, coronary heart disease, bronchial asthma, hypo- and hyperthyroidism, gastric ulcer, etc.);
• chronic lack of sleep, sleep disorder;
• sudden changes in weather conditions or prolonged stay in a place with severe climatic conditions;
• the presence of foci of infectious agents (chronic sinusitis, rhinitis, otitis, tonsillitis, etc.);
• bad habits (smoking, alcoholism, drug addiction).

There are certain risk groups, people from whom are more likely than others to develop VSD: people who are underweight or overweight, have low resistance to stress, and occupy responsible positions; girls during puberty, women during pregnancy and menopause.

Treatment

Therapeutic measures consist of a set of effective methods, each of which is selected individually. Since most of the occurrences of VSD occur due to stress, it makes sense to pay attention to ways to combat them:

• normalization of sleep;
• rejection of bad habits;
• building an adequate work and rest regime, if necessary, the issue of changing jobs is considered;
• nutritious nutrition in compliance with the meal schedule;
• performing special sets of physical exercises, therapeutic exercises, yoga;
• work with a psychologist (individual or group classes, psychological trainings, consultations);
• physiotherapeutic procedures (massage, electrophoresis, contrast and therapeutic showers, etc.);
• Spa treatment.

All of the above methods are quite effective; when used, not only the disappearance of VSD symptoms is noted, but also an overall positive effect on the body as a whole.

Drug therapy for VSD

Prescription of medications is resorted to in case of ineffectiveness of non-drug measures. Treatment of VSD involves the use of medications strictly as prescribed by the doctor. Only a specialist determines the necessary drugs, their dosage and frequency of administration in each specific case. Among the main groups of medications are:

• sedatives of plant origin (normalize sleep, have a mild and effective effect);
• antidepressants – reduce anxiety, relieve headaches of varying intensity and duration;
• tonic and restorative drugs (improve tone, increase resistance to stress, physical and mental stress);
• metabolic agents – improve and normalize metabolic processes in the body, in particular in the brain and nervous system;
• tranquilizers - prescribed with caution, as they have clear indications and many side effects;
• microelements and vitamins;
• drugs aimed at eliminating various specific symptoms and their causes (hypotensive, antiarrhythmic, prokinetics, antispasmodics, etc.).

The patient must understand that VSD does not belong to the category of severe pathologies. With proper treatment and strict adherence to medical recommendations, recovery is guaranteed. The right attitude towards recovery plays an important role, when a person is not afraid of the manifestations of dystonia, but strives to overcome them. This is especially true for attacks of anxiety, restlessness, and various phobias - as soon as the groundlessness of such fears is realized, they gradually disappear forever.

Therefore, it is very important not to be afraid to talk about the problem. Sometimes patients are embarrassed by this and are in a vicious circle when they cannot cope with the problem on their own, but do not dare to visit a doctor. And it’s completely in vain, because already during a conversation with a specialist it turns out that it is much easier to cope with the situation together, moreover, the prognosis is favorable.

Causes

Doctors believe that the appearance of panic attacks during VSD is provoked not by one, but by several factors at once. Among the reasons are:

• unhealthy sleep;
• constant presence in stressful situations;
• headache;
• fatigue, overstrain;
• the appearance and further development of osteochondrosis in the cervical spine;
• character traits of a person. For example, suspiciousness;
• presence of a diagnosis of PA in relatives;
• unhealthy lifestyle: drinking alcohol, using drugs, smoking.

Doctors treating VSD

In addition to the attending physician, a neurologist, endocrinologist, otolaryngologist, ophthalmologist, and instrumental diagnostic specialists take part in the process of diagnosing VSD. Depending on the symptoms, you may need to consult a specialist doctor - cardiologist, gastroenterologist, pulmonologist, urologist and other related specialties.

At the clinic of JSC “Medicine”, a comprehensive approach allows us to accurately establish the mechanisms of the occurrence and development of VSD, triggers, and timely identify or exclude concomitant pathologies. Doctors of the highest category with many years of experience, doctors of medical sciences, practice here. This is the key to successful treatment, but much depends on the patient himself: how timely he sought qualified medical help, how carefully he followed the doctor’s instructions for diagnosis and treatment.

Treatment and prognosis

In patients with vegetative-vascular dystonia, treatment is carried out under the supervision of doctors of the following specializations: therapist, neurologist, endocrinologist, psychiatrist. Certain prescriptions will depend on the predominant symptoms of VSD. Usually, taking into account the nature and etiology of the disease, complex long-term individual therapy is carried out.

Physical therapy classes

Special physical education is most useful in the treatment of VSD in both adults and children. Such exercises have a general strengthening effect and are an excellent way to train the whole body and improve performance. Designed for the treatment of VSD and thought out taking into account age and health status, physical therapy should also exclude jumping. In general, an active lifestyle can be an integral component of the prevention of vegetative-vascular dystonia.

Undergoing physical therapy

Therapeutic massage, water treatments, and reflexology also have a positive effect in the treatment of VSD. The physiotherapeutic effect is selected depending on the type of disease: it can be electrophoresis with calcium or caffeine (in the case of vagotonia) or with magnesium, papaverine or bromine (for the treatment of sympathicotonia).

Use of drug treatment

If general strengthening and physiotherapeutic measures are insufficient for the effective treatment of VSD, the specialist individually selects drug therapy, which may include the following drugs:

• sedatives that reduce the activity of autonomic reactions, antidepressants, nootropics;
• beta-blockers and herbal psychostimulants that help reduce vegetative-vascular manifestations;
• Vitamin-mineral complexes usually have a beneficial general strengthening effect.

If necessary, to treat various forms of VSD, a course of therapy is also carried out aimed at eliminating chronic foci of infection, concomitant endocrine or somatic pathology. The doctor regularly monitors a patient with vegetative-vascular dystonia. Clinical examination may be prescribed (every 3-6 months), especially in the autumn-spring period.

Indications for treatment

The main indication is a clinically confirmed diagnosis of vegetative-vascular dystonia. Since VSD is a syndrome, the indications for its therapy correspond to disorders of various etiologies: vascular, psychological, neurological, cardiological and many others.

If your professional responsibilities involve high mental and emotional stress, stressful situations, overwork, or if you have a hereditary predisposition to VSD, sign up for a consultation with a specialist. Timely prevention will help avoid worsening problems, because the disease is easier to prevent than to treat.

About vegetative-vascular dystonia

Vegetovascular dystonia (in other words, autonomic dysfunction) is a disorder of the autonomic nervous system.

The autonomic nervous system is part of the nervous system that regulates many processes in the internal organs. It is sometimes called the autonomic nervous system because... regulation occurs autonomously, i.e. without the participation of human consciousness. The autonomic nervous system conventionally has two divisions: sympathetic and parasympathetic, which are responsible for oppositely directed actions: for example, the parasympathetic division stimulates digestion, and the sympathetic one slows it down. Normally, the parasympathetic and sympathetic systems are in balance without predominance of one over the other.

Vegetovascular dystonia is an imbalance in the autonomic nervous system, the consequence of which is disruption of the functioning of internal organs. Vegetative-vascular dystonia affects up to 70% of the adult population and 15-25% of children.

Contraindications

Contraindications for the treatment of VSD are determined by the methods used. If we talk about drug therapy, then almost every drug has contraindications for use. The same can be said about physiotherapeutic procedures. That is why the course and tactics of treatment are determined by a highly qualified doctor who is able to take into account all factors.

There is one contraindication that is simultaneously applicable in all cases - self-treatment. In the case of VSD, this is especially true, since such patients are often excessively suspicious and tend to attribute severe pathologies to themselves. In an attempt to treat a non-existent disease, they can not only significantly aggravate their situation, but also cause irreparable harm to the body.

Cost of initial appointment, diagnostic examinations and treatment

As for the initial appointment, its cost in most cases is low; in fact, it is a consultation procedure. But one should not neglect its importance - an experienced doctor is able to recognize characteristic symptoms and notice even small but important manifestations of abnormalities.

The price of diagnostic procedures and laboratory tests may vary significantly in different clinical cases. For one patient, general tests and several examinations will be enough; for another, diagnosis may take longer and require additional studies and tests. This is due to both the complex nature of VSD and the individual characteristics of each patient’s body.

A similar picture is typical for treatment. Its cost is determined by many factors; sometimes the therapeutic process has to be adjusted. To roughly navigate the prices for diagnosis and treatment of VSD in Moscow, you can familiarize yourself with the corresponding table of costs for the most common diagnostic procedures.

Low blood pressure - causes and symptoms

Low blood pressure is also a complication of VSD, causing no less trouble for patients. The patient's body reacts to irritating factors by dilating peripheral vessels, and inhibition dominates in the central nervous system. Patients justify low blood pressure for themselves with all sorts of secondary reasons, without noticing other symptoms.

The most common symptoms of low blood pressure are:

• excessive weakness;
• pathological fatigue;
• increased drowsiness, light sleep itself, frequent nightmares;
• dizziness to the point of fainting;
• impairment of cognitive functions (memory, attention, concentration).

Advantages of treating VSD at the clinic of JSC "Medicine"

Vegetative-vascular dystonia is a multifactorial disorder in the body; its successful treatment requires an integrated approach and coordinated work of doctors of many specialties. Among the undeniable advantages of JSC “Medicine” (clinic of academician Roitberg), it is worth mentioning 3 key points:

1. High professionalism of doctors - the staff consists of more than 300 experienced practicing doctors and diagnosticians of 67 medical specialties. Leading corresponding members of the Russian Academy of Sciences, academicians, professors, doctors and candidates of medical sciences advise here. The clinic was the first in Russia to receive accreditation according to the international standards for assessing the quality of medical care JCI. Joint Commission International, considered the highest level of accreditation worldwide.
2. Ultra-modern technical base - equipped with the latest generation diagnostic and treatment equipment from the world's leading manufacturers. This allows you to create your own scientific and clinical developments in almost all medical areas. For many years, the clinic of JSC "Medicine" has served as a clinical base for the Department of Therapy and Family Medicine of the Russian National Research Medical University named after N.I. Pirogov (RNIMU) and is among the innovatively active healthcare institutions in Moscow.
3. High-quality medical care - the effectiveness and safety of treatment is guaranteed by the principle of Academician N.A. Semashko, which states: “One patient - one doctor.” The attending physician is assigned to each patient and works closely with colleagues from related medical specialties. A developed diagnostic base and medical care technology built according to international standards make it possible to make a diagnosis at an unprecedented speed. In just 1 day from the moment of the initial examination and diagnostic measures, you can receive detailed results of laboratory tests, detailed diagnostic reports and doctor’s recommendations.

It is important to know: VSD is not a critically severe disorder, but can provoke one in the absence of proper medical care. In case of early access to a doctor, treatment time is significantly reduced and financial costs are reduced. Don’t delay your visit, make an appointment at a time convenient for you, and we will help you regain your health!