Emotional Stress in the Precipitation of Congestive Heart Failure

Abstract

Twenty-five consecutive hospital admission patients with congestive heart failure were studied systematically to determine the contributing factors in development of the disorder; the study included psychiatric interviews. In 19 of the 25 patients emotional tension was felt to be responsible for increasing the work load beyond cardiac capacity and thus to be directly responsible for the congestive heart failure. In the 19 cases the emotional tension resulted either from feelings of rejection and loss of security or from feelings of frustation and rage. Emotional factors were also found to outweigh organic factors in the precipitation of congestive failure in 4 of 5 additional patients who were studied on a long-term basis. In these patients it was found that "compensation was maintained as long as the patient-physician relationship was satisfactory; but as soon as this relationship was threatened, the patients again developed congestive heart failure." Pertinent material from case histories of the patients is included in an appendix.