| Skumin syndrome | |
|---|---|
| Classification and external resources | |
Victor A.Skumin, 1978 |
|
| ICD-10 | F48.8 |
| ICD-9 | 300.8 |
Skumin syndrome is a specific mental disorder, which a quarter of the patients develop after the prostheses of the valve heart device and manifests with persistent doubts about the reliability of the implant, fear of its breakdown, fixed negative attitude to physical and psychoemotional load, specific sleep disorder, feeling of anxiety, mental confusion and depression[1] [2]
Contents |
This disease was described in 1978 by Victor A. Skumin[3] and called "cardioprosthetic psychopathological syndrome".[4] V. Skumin for the first time studied the etiology, pathogenesis and the disease pattern, worked out methods of its diagnostics, treatment, prophylaxis, effective system of rehabilitation measures, programme of culture of health basics fostering to that cohort of people. The stated above was based on the research lead in the Nikolai Amosov Institute.
The main aim of medical science is to maintain the most effective methods of heart diseases treatment as basic cause of disablement and death rate of the population. Prosthetic appliance for valve apparatus of the heart is worked out and successfully used.
Etiopathogenetic mechanisms, which cause its origin, are as follows:
The state into which hospitalized patients get after a long conservative therapy is notable for characteristic features:
Cardiosurgical situation, being extreme and psychotraumatic by its character, affects a patient’s psychics in the preoperative period. The mental condition of a patient after the operation undergoes notable changes, which are caused by specific cardiosurgical procedure and peculiarities of an implanted prosthesis functioning in the body.
After the implantation of artificial heart valves, basically with the psychopathological type of a person’s reaction, patients have a special complex of mental disorder – Skumin syndrome.
Skumin syndrome has a typical disease pattern. Thinking and behaviour of patients differ specifically. The attention is concentrated on the prosthesis functioning. There appear unusual sensations from a heart when a person fears possible break-down of artificial valves, ball splitting and tearing off a prosthesis. A person is depressed, miserable, alarmed, with a special kind of dismay (how to live with "a piece of iron in the heart", with a prosthesis in the "motor of life"). Patients tend to keep themselves away from petty physical or psycho-emotional tenseness, introducing inadequate self-restrictions in the routine. They avoid walks, medical physical training and other adequate work, supposing this can prevent early wear of artificial valves. Sleep disorder is typical of 79.6% of the patients. At night they cannot fall asleep because they listen to a heart beat, count the number of extrasystoles, note petty changes in the heart rhythm and melody of the implanted prosthesis. On the contrary, in the daytime, when it is noisy they can have sound sleep. Neurologically a patient has vegetative faults – painfulness in the zones of solar plexus and carotid artery, arterial hypotension. The research registered faults in mental activity of the patients with a prosthesis. It considerably hampers the realization of rehabilitation programmes. Systematic use of special psychotherapeutic and prophylactic measures is required for the correction and prevention of these faults.[5]
There is the system of psychotherapy and psychoprophylaxis in rehabilitation of the patients with heart valve prosthesis. Preparatory stage:
Sedative-mobilizing stage:
Psychotraining according to V. Skumin is one of the effective psychotherapeutic methods and it includes five exercises:
Special attention is paid to relaxation of hands, back, face, excessive tenseness of which is especially expressed in this cohort of people.
Patients with artificial heart valves and Skumin syndrome suffer from the cold in peripheral area. Elimination of unpleasant feelings, besides its positive effect, leads to a person’s encouragement in the fight against the disease.
Having mastered this exercise one feels reduced pain, less heavy weight, which is characteristic of such patients; their mood and health improve.
They are targeted on developing adequate attitude to the work of implants, normalization of sleep, correction of character deviations, overcome of fears and uneasiness, mobilization of personal resources.
It is stressed that a body is charged with energy, force, and it heads to health restoration and further health improvement. The five exercises according to V. Skumin are the most optimal and highly effective means of mental selfregulation, which lead to quick stabilization of mental condition and have a positive influence on self-esteem and medical state. By the whole, inclusion of mental rehabilitation into medical-management programmes eliminates and predicts the progress of psychological adaptation.
Leading role psychotherapies in the treatment Skumin syndrome and does not exclude the application of psycho-pharmacological preparations, although one should remember about the cardiotoxic action of some of them.