NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)
Patients presenting with health anxiety or fear of cardiovascular disease (cardiophobia) require a systematic cardiovascular examination, resting ECG, and targeted cardiovascular risk factor assessment (blood pressure, lipid profile, glycemic status) to rule out organic disease. Once acute coronary syndromes and structural pathology are excluded, provide clear explanation of somatic anxiety symptoms (such as sinus tachycardia or palpitations) and structured reassurance. Offer referral for cognitive behavioral therapy or psychological support if health anxiety causes severe functional impairment or compulsive reassurance-seeking. - Refer
Children follow the same pathway: recognise and refer. No primary-care medicine is implied.
No dose - referral pathway, no medicine given in primary care
Patients presenting with health anxiety or fear of cardiovascular disease (cardiophobia) require a systematic cardiovascular examination, resting ECG, and targeted cardiovascular risk factor assessment (blood pressure, lipid profile, glycemic status) to rule out organic disease. Once acute coronary syndromes and structural pathology are excluded, provide clear explanation of somatic anxiety symptoms (such as sinus tachycardia or palpitations) and structured reassurance. Offer referral for cognitive behavioral therapy or psychological support if health anxiety causes severe functional impairment or compulsive reassurance-seeking.
- RED FLAG - Hemodynamically significant sustained arrhythmias: assess urgently and refer.
- RED FLAG - Acute dyspnea, orthopnea, or pulmonary edema: assess urgently and refer.
- RED FLAG - Exertional syncope or presyncope: assess urgently and refer.
- RED FLAG - Acute crushing chest pain radiating to the jaw, neck, or left arm: assess urgently and refer.
- Must rule out genuine angina, arrhythmia, or evolving myocardial infarction before attributing symptoms to anxiety alone.
- No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.