Emotions, Behavioral Traits and Heart Disease

The appreciation that different emotions could have powerful influences on the heart and the recognition of some intimate but poorly understood mind-heart connection is hardly new. Aristotle and Virgil actually taught that the heart rather than the brain was the seat of the mind and soul and similar beliefs can be found in ancient Hindu scriptures and other Eastern philosophies.

Some 2000 years ago, the Roman physician Celsus unwittingly acknowledged this mind-heart relationship by noting that "fear and anger, and any other state of the mind may often be apt to excite the pulse." Our earliest uses of the word heart clearly indicate its conceptualization as the seat of one's innermost feelings, temperament, or character. Broken-hearted, heartache, take to heart, eat your heart out, heart of gold, heart of stone, stouthearted, are just a few of the words and phrases we still use that vividly symbolize such beliefs.

William Harvey, who discovered that the circulation of the blood around the body through vessels was due to the mechanical action of the heart also recognized that the heart was more than a mere pump. As he wrote in 1628, "every affection of the mind that is attended either with pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart."(Harvey, 1628) During the 18th century, John Hunter, who elevated surgery from a mechanical trade to an experimental science, suffered from angina, and being a keen observer complained, "my life is in the hands of any rascal who chooses to annoy and tease me." He turned out to be somewhat of a prophet, since it was a heated argument with a colleague that precipitated his sudden death from a heart attack.

With respect to personality and Type A behavioral traits, Von Düsch, a 19th century German physician, first noted that excessive involvement in work appeared to be the hallmark of people who died from heart attacks. (Von Düsch, 1868) He did not imply that job stress was the culprit, but rather that such individuals seemed to be preoccupied with their work and had few outside interests. Over 100 years ago, Sir William Osler, an astute clinician, succinctly described the coronary-prone individual as a "keen, and ambitious man, the indicator of whose engines are set at 'full speed ahead". (Osler, 1892) He later wrote that he could make the presumptive diagnosis of angina based on the appearance, demeanor and mannerisms of the patient in the waiting room and how he entered the consultation room.