Heart to Heart

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Universally, the heart is used to represent our emotions.  We use this metaphor in our everyday language.  We watch tragic stories on the news and say they “break our hearts.”  We sometimes say we “don’t have the heart” to deliver bad news, and we proclaim we love our children “from the bottom of our hearts.”

The metaphor is also present in the pop culture that surrounds us.  We hear songs that tell us to “listen to” and “put a little love in” our hearts.  We read poems and books and watch movies that portray the heart as a symbol of our deepest feelings.  As children, we all watched the Grinch’s heart grow three sizes the moment he learned to love (which, by the way, is the worst case of cardiomegaly I have ever seen.  He needs a to see a doctor right away).

Early references to this metaphor exist in the writings of ancient Greek philosophers.  Aristotle, for example, is quoted as saying “Educating the mind without educating the heart is no education at all.”  Thus, this metaphor has been around much longer than we have.

I wonder how this metaphor came to be.  Why did whoever the first person was to use it choose to connect our heart and our emotions?  Is it possible he somehow knew this idea went beyond figures of speech?   Because it seems that the link between our cardiac organ and our emotions may be more than figurative.  Some would argue that scientific and experiential evidence prove that there is a literal and physical link between the two.

For example, a study by the Institute of Heartmath examined the electrocardiograms of subjects while they experienced different emotions.  The researchers found that the when we experience negative emotions like anger and anxiety, our heart rhythm becomes more erratic.  On the other hand, when we are feeling positive emotions such as compassion and love, the heart’s rhythm produces a “smooth pattern…like gently rolling hills.”

There is also a book titled The Heart Speaks by Dr. Mimi Guarneri.  In it, Dr. Guarneri discusses how working as a cardiologist for many years taught her how much more there is to heart health than physical factors like cholesterol and plaque build-up.  She believes and asserts that stress-inducing situations such as the death of a loved one are just as important and that in treatment of the heart, doctors must tend to both the physical and the emotional risk factors.

Most convincing, is the existence of a disease that is actually called broken heart syndrome, AKA stress cardiomyopathy.  In recent years, broken heart syndrome has been recognized by the medical community as a real and dangerous condition.  It occurs when extreme emotional stress causes the heart muscle to rapidly and severely weaken and often happens after a major stress event that causes extreme grief or fear, or even anger and surprise.

Just as these examples prove that negative emotions can have a negative impact on our heart, the reverse is also true.  After open heart surgery, the heart needs to recover from the trauma of the procedure; this physical factor can have an emotional consequence.  That may be why depression is common during recovery from open heart surgery.  Of course, other surgeries can also cause depression, but some experts say that cardiac surgery has one of the strongest correlations with depression.

After my surgery in 1997, all I wanted to do was lay under my covers in my bed and watch TV.  I didn’t feel like going out with my friends or going to cheerleading or doing any of the things that I normally loved.  Eventually, in a very Bette-Midler-in-Beaches fashion, my best friend gave me a stern lecture about moving on with my life and not acting as if I were dying.  She got through to me and that day I pulled back the covers and began to have fun again.

In 2010, my post-surgery depression came in the form of feeling neglected.  Through tears, I told my sister how no one ever came to visit me and the fact that they didn’t meant they didn’t care about me.  In retrospect, I was clearly depressed.  Rationally, I know that people did come to visit and that now that my friends were married with jobs and children, they couldn’t sit around me on my bed as they had after my high school surgery.  They were there whenever they could be, but my depressed emotional state was telling me otherwise.

My personal experience with the connection between my emotions and my heart health does not end there.

My defibrillator (a device that detects cardiac arrhythmia and then treats it with an electric shock) was implanted in December 1997.  Five years passed before I needed any help from my device.  Then, on September 11, 2001, my father was killed in the terrorists attacks at the World Trade Center.  I cannot possibly sum up this experience in this short paragraph, so I will not try.  My father’s first birthday after his death was on March 13, 2002.  As a family, we visited Ground Zero for the first time.  A few hours later, as I walked through a parking lot with my then boyfriend, I felt a strange sensation in my chest as if someone was pulling my heart toward my spine and then BOOM.  My defibrillator had gone off.  For the first time.  On my father’s birthday.  On the day I had seen the place of his death for the first time.  It is hard to argue that there wasn’t an emotional connection between my emotional experience of that day and the behavior of my heart.

The next five years were also emotionally difficult.  It was during this time that I developed issues with anxiety and that panic attacks became a regular part of my life.  And my heart rhythm continued to be problematic.  My defibrillator shocked me 10-11 times in that period.  Again, emotional distress → erratic heart rhythm.

Then in 2005 I met Anthony and my life began to fall into place with him by my side.  Of course, it did not happen instantaneously but eventually, the arrhythmia events ceased and did not occur again for several years.  Hence, emotional happiness → gently rolling hills.

After my 2010 surgery, because of new scar tissue and other results of the surgery, I started to have some rhythm events that still happen now and then.  My defibrillator has not shocked me (knock on wood) because I haven’t had a true arrhythmia.  Instead, my heart sort of becomes stuck in a very rapid heartbeat.  I take extra medicine and lay down until it stops.

Last week, one of these rapid heartbeats occurred on a particularly upsetting day.

Earlier that day, I went for my biannual appointment with my cardiologist.  A little background info: when I had the surgery in 2010, my tricuspid valve was supposed to be repaired.  Unfortunately, the surgeon’s other tasks took up more time than anticipated and he could not get to it.  So the little guy is still leaking.  And he needs to get fixed.  This has been the ongoing question of my cardiac care since the fall of 2010:  when and how we will tackle this problem.

So, two Mondays ago, I sat in my cardiologist’s exam room atop the paper covered table while he explained that he wants me to have a stress test in the next few weeks.  My performance on this test will determine whether or not I will have the surgery now or if we will put it off.  I have never done well on a stress test before, so chances are I will not do well on this one either.

Okay, I am obviously not thrilled.  I didn’t want to need open heart surgery while I have a baby to take care of.  I will not get into the specifics of my feelings about this surgery; they are mixed and complicated.  I will just say that some of these feelings are strongly negative.

That evening, I sat on my couch on the phone with my friend who had called to see how the doctor went.  I told her all about it and just as we were hanging up the phone, I felt the familiar sensation of my heart jumping into a faster rhythm.  I checked my pulse and, sure enough, I was having a rapid heartbeat.  It did not last long.  I took my medicine but my heart returned to a normal rhythm before I could even swallow the pill.

But it made me wonder.  Why did this happen tonight of all nights? Is my heart responding to my emotions? Do our emotions directly affect the health of our heart?

After looking at the scientific evidence and examining my own experiences, I do believe the link exists and that negative emotional experiences can have a negative impact on our cardiac health.  Of course, that does not mean that emotions are always the cause of heart ailments.  Many times in the past, I have had cardiac issues at a time that I was not emotionally distressed.  On the other hand, there are times when I am distressed and my heart does not react in any way.   Sometimes, perfectly happy people have heart attacks, congestive heart failure, or arrhythmias.

But, still, there is plenty of proof that our emotions can affect our heart health.  And if that’s true, than people with heart disease need to not only take care of themselves physically, but emotionally as well.  Just as much as we need to eat right and exercise, we also need to work through our stress, overcome our depression, and learn to control our anxiety.  In many ways, those emotional tasks may prove to be far more challenging than the physical ones.




  1. Does your heart sense your emotional state? – NBC News
  2. FAQs about Broken Heart Syndrome – Johns Hopkins Medicine