The characteristic symptoms and clinical findings of effort syndrome still constitute the fundamental basis for diagnosis. The chief manifestations are palpitation, dyspnea, precordial distress, and exhaustion, all of which are aggravated by mild exercise. When the symptoms are typical and there is no evidence of heart disease on physical examination, radiologically, and electrocardiographically, diagnosis is easy. In the presence of organic heart disease, diagnosis is rendered more difficult. It can still be established, in most such instances, by a careful correlation of the nature and extent of the avowed disability with the demonstrable evidence of heart disease. Tests of effort tolerance and of the response to hyperventilation have been devised to assist in demonstrating the neurotic basis for the altered functional capacity, but they have not enjoyed wide usage.
The effort syndrome may superficially resemble hyperthyroidism, but differentiation is seldom difficult if one is familiar with the physiological effects of