PSYCHOSOMATIC ASPECTS OF CARDIAC ARRHYTHMIAS: A PHYSIOLOGICAL DYNAMIC APPROACH

Abstract

While the heart by virtue of its inherent pacemaker is capable of rhythmic contractions when removed from the body, in situ it becomes a constant target for psychic and somatic stimuli. Utilizing some of the knowledge gleaned from exptl. neurology, psychiatry, and classical cardiology, an attempt was made to trace the relay of events of a psychic stimulus originating in the cerebral cortex to final disordered heart action. Electrical stimulation of the cerebral cortex close to the precentral sulcus, the hypo-thalamus or the cardioregulatory centers elicites cardiac arrhythmia; the impulses being mediated through the auto-nomic nervous system. The latter system is closely integrated with endocrine function which under certain clinical and exptl. conditions produces profound effects on the cardiac mecha-nism. Psychic and endocrine stimuli produce cardiac irregularities in both normal and in diseased hearts. While in the former instance, the effect may take the form of a somatic discomfort or an anxiety state, in the latter it may impose a serious load on an already diseased myocardium. Psychotherapy with the aid of simple drugs usually employed for cardiac arrhythmias may be successful in the rehabilitation of a patient with neurotic behavior accompanied by somatic complaints referable to the heart.