A 13-year-old girl complains of periodic prickly pain in the heart region. Percussion revealed no changes of cardiac borders. Auscultation revealed arrhythmic enhanced heart sounds, extrasystole at the 20-25 cardiac impulse. ECG showed the sinus rhythm, impaired repolarization, single supraventricular extrasystoles at rest. What is the most likely diagnosis?

Answer options

1. Myocardial degeneration
2. Rheumatism
3. Nonrheumatic carditis
4. Somatoform autonomic dysfunction
5. Intoxication syndrome

Explanation

In this task, it is necessary to differentiate organic cardiac pathology and functional dysfunction of the nervous system. Objective methods of examination showing a child have subjective cardiac complaints and there are signs of sinus arrhythmia (periodic prickly pain in the heart region, arrhythmic enhanced heart sounds, extrasystole). The instrumental method of examination showed the presence of single supraventricular extrasystoles. These symptoms are signs of functional abnormalities of a nervous system. So, in this task correct answer is somatoform autonomic dysfunction.Psychiatry: [Textbook] V.L. Gavenko, V.M. Sinayko, G.A. Samardakova and others; reduction by V.L. Gavenko, – Kharkiv Region-inform, 2006. – P. 298 – 299, 308 P.