What is vegetovascular dystonia?
Vegetovascular dystonia (VVD), also known as neurocirculatory dystonia, is a complex of symptoms associated with the dysregulation of internal organs and systems by the autonomic (vegetative) nervous system. In modern Western medicine, the term "VVD" is often viewed as a syndrome rather than an independent disease and is used to describe functional disorders when no organic pathology can be identified. The autonomic nervous system (ANS) is responsible for involuntary bodily functions such as heartbeat, breathing, digestion, thermoregulation, and blood pressure. It consists of two divisions: the sympathetic division, which activates the body in stressful situations ("fight or flight"), and the parasympathetic division, which is responsible for relaxation and recovery. An imbalance between these two divisions can lead to diverse and sometimes debilitating symptoms.
The diversity of symptoms: why is it so complex?
Symptoms of VVD can be extremely diverse and affect virtually any body system, making diagnosis difficult and often causing anxiety in patients. The most frequent manifestations include:
- Cardiovascular: rapid heartbeat (tachycardia), chest pain, fluctuations in blood pressure (both increase and decrease), sensation of heart "skipping a beat".
- Respiratory: feeling of a lack of air, shortness of breath, difficulty inhaling, "lump in the throat".
- Digestive: abdominal pain, nausea, stool disorders (constipation or diarrhea), heartburn. These symptoms may overlap with manifestations of other functional disorders, such as irritable bowel syndrome (IBS). IBS, for example, is a highly prevalent chronic disorder that significantly reduces patients' quality of life [4].
- Neurological: headaches, dizziness, fainting, sleep disorders, increased fatigue, weakness.
- Thermoregulatory: chills, hot flashes, increased sweating, cold extremities.
- Psychoemotional: anxiety, irritability, panic attacks, mood swings.
The diversity of symptoms is explained by the broad influence of the ANS on the entire body. For example, gastroesophageal reflux disease (GERD) can manifest not only with typical symptoms (heartburn, regurgitation) but also with extra-esophageal manifestations such as respiratory disturbances, which highlights the complexity and variety of functional connections in the body [7].
Diagnosis: ruling out serious pathologies
Since VVD symptoms are non-specific and can mimic many organic diseases, the key stage of diagnosis is a thorough exclusion of other, more serious pathologies. This requires a comprehensive examination, which may include:
- General and biochemical blood and urine tests.
- Electrocardiography (ECG), 24-hour ECG and blood pressure monitoring.
- Ultrasound examination of internal organs.
- Consultations with narrow specialists: cardiologist, neurologist, endocrinologist, gastroenterologist.
An example of such an approach is the diagnosis of irritable bowel syndrome (IBS), where it is recommended to use a "positive diagnostic strategy" instead of an elimination strategy. This allows for adequate therapy to be started sooner and also includes serological testing to rule out celiac disease in patients with IBS and diarrhea [4]. A similar principle applies to VVD: after ruling out organic causes, attention shifts to the functional nature of the disorder.
The psychoemotional factor and VVD
One of the central roles in the development and exacerbation of VVD symptoms is played by the psychoemotional state. Stress, anxiety, depression, and other psychological factors can significantly influence the functioning of the autonomic nervous system, amplifying or provoking physical manifestations. Numerous studies show that depression and anxiety affect treatment outcomes, are risk factors for complications, chronic pain, and readmission, for example, in patients with chronic discogenic back pain [8]. This principle also applies to VVD, where mental stress often becomes a trigger or aggravating factor for somatic symptoms.
Panic attacks, often associated with VVD, are a prime example of the interaction between mind and body, when intense fear and anxiety trigger violent autonomic reactions: rapid heartbeat, shortness of breath, dizziness, sweating, and a feeling of unreality.
Modern approaches to treatment and condition management
Given the multifactorial nature of VVD, treatment must be comprehensive and individualized. It is aimed not only at eliminating symptoms but also at correcting lifestyle, psychoemotional state, and increasing the body's adaptive capabilities. For complex conditions such as Wolfram syndrome, an interdisciplinary approach is necessary to prevent the progression of neurodegenerative changes [1]. This principle is also relevant for VVD, which requires the coordinated efforts of various specialists.
Main areas of treatment:
- Lifestyle modification:
- Regular physical activity (moderate exercise such as walking, swimming, yoga).
- Balanced diet.
- Sufficient sleep (7-9 hours per day).
- Quitting harmful habits (smoking, alcohol abuse, caffeine).
- Stress management:
- Relaxation techniques (breathing exercises, meditation, autogenic training).
- Psychotherapy, especially cognitive behavioral therapy (CBT), which helps change negative thought patterns and behavioral responses to stress and symptoms.
- Learning self-regulation and emotional resilience skills.
- Pharmacological therapy:
- Prescribed by a doctor to relieve the most pronounced symptoms. These can include beta-blockers for tachycardia, drugs to normalize blood pressure, anxiolytics (anti-anxiety medications), or antidepressants for pronounced anxiety and depression.
- Drugs that improve cerebral circulation and nerve cell metabolism.
- Physiotherapy:
- Water procedures (contrast shower, therapeutic baths).
- Massage.
- Electrosleep therapy.
The importance of an individual approach
Treatment for VVD should always be strictly individual, taking into account the prevailing symptoms, psychoemotional background, and the patient's bodily characteristics. Regular monitoring by a doctor and open discussion of all disturbing manifestations allow for adjusting therapy and achieving the best results. Understanding that VVD is a functional disorder rather than a life-threatening disease helps patients cope with anxiety and actively participate in the recovery process, significantly improving their quality of life.
Sources
- [1] Metabolic Treatment of Wolfram Syndrome. (International Journal of Environmental Research and Public Health, 2022) https://pubmed.ncbi.nlm.nih.gov/35270448/
- [4] ACG Clinical Guideline: Management of Irritable Bowel Syndrome. (The American Journal of Gastroenterology, 2021) https://pubmed.ncbi.nlm.nih.gov/33315591/
- [7] Review article: gastro-oesophageal reflux disease in asthma and chronic obstructive pulmonary disease. (Alimentary Pharmacology & Therapeutics, 2018) https://pubmed.ncbi.nlm.nih.gov/29193245/
- [8] Incidence of Anxiety and Depression in Adult Patients with Chronic Discogenic Back Pain. (Psychiatria Danubina, 2024) https://pubmed.ncbi.nlm.nih.gov/39378464/
The information presented in this article is for informational purposes only and cannot replace professional medical advice. Always consult a specialist for the diagnosis and treatment of diseases.