title: The Khmer 'Weak Heart' Syndrome: Fear of Death from Palpitations.
abstract: According to the Khmer conception, a person suffering 'weak heart' (khsaoy beh daung) has episodes of palpitations on slight provocation (e.g. triggered by orthostasis, anger, a noise, worry, an odor or exercise) and runs the risk of dying of heart arrest during these periods of palpitations; too, the sufferer typically has other symptoms attributed to the purported cardiac dysfunction: fatigue, shortness of breath, and orthostatic dizziness. Many Khmer refugees suffer this cultural syndrome, an anxious-dysphoria ontology, most probably of French colonial provenance. The syndrome demonstrates considerable overlap with those Western illness categories that feature panic attacks, in particular post-traumatic stress disorder (PTSD) and panic disorder. In a psychiatric clinic survey, 60 percent (60/100) of those assessed believed themselves to currently suffer 'weak heart'; 90 percent (54/60) of those considering themselves to suffer from 'weak heart' thought that palpitations (e.g., those resulting from a loud noise or orthostasis) might result in death. The article illustrates the profoundly culturally constructed nature of 'cardiac sensations,' located in a specific historical trajectory and episteme; too, the article suggests that trauma may result more in panic disorder than 'PTSD' when autonomic arousal symptoms (in the present case, palpitations) are considered potentially life-threatening.
authors.affiliation: Harvard University.
authors.forename: Devon
authors.initials: D
authors.lastname: Hinton
authors.forename: Susan
authors.initials: S
authors.lastname: Hinton
authors.forename: Khin
authors.initials: K
authors.lastname: Um
authors.forename: Audria
authors.initials: A
authors.lastname: Chea
authors.forename: Sophia
authors.initials: S
authors.lastname: Sak
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