How your emotions change the shape of your heart | Sandeep Jauhar

Sep 10, 2019

"A record of our emotional life is written on our hearts," says cardiologist and author Sandeep Jauhar. In a stunning talk, he explores the mysterious ways our emotions impact the health of our hearts -- causing them to change shape in response to grief or fear, to literally break in response to emotional heartbreak -- and calls for a shift in how we care for our most vital organ.

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this Ted talk feature is physician and writer Sandeep Joe are recorded live at Ted Summit 2019 hello it's Chris Anderson here host of the Ted interview podcast on our next episode one of the world's most famous introverts Citizen Kane we talk about the science of introversion and how she pushed past her and reversion to give her Ted Talk I signed up for the seminar in public speaking anxiety and you would just say your name and then sit back down and declare Victory subscribe to the Ted interview wherever you listen

no other organ perhaps no other object in human life is as imbued with metaphor and meaning as the human heart over the course of history the heart has been a symbol of our emotional lives it was considered by many to be the seat of the soul the repository of the emotions the very word emotion stems in part from the French verb and move wha meaning to stir up and perhaps it's only logical that emotions would be linked to an organ characterized by its agitated movement but what is this link is it real or purely metaphorical

as a heart specialist I'm here today to tell you that this link is very real emotions you will learn can and do have a direct physical effect on the human heart

but before we get into this let's talk a bit about the metaphorical heart the symbolism of the emotional heart indoors even today if we ask people which image they most associate with love there's no question that the valentine heart would top the list the heart shape called a cardioid is common in nature is found in the leaves flowers and seeds of many plants including silphium which was used for birth control in the Middle Ages and perhaps is the reason why the heart became associated with sex and romantic love

whatever the reason Hearts began to appear in paintings of lovers in the 13th century over time the pictures came to be colored red the color of blood a symbol of passion in the Roman Catholic Church the heart shape became known as The Sacred Heart of Jesus adorned with thorns and emitting ethereal light it became an Insignia of monastic love this association between the heart and love has withstood modernity when Barney Clark

a retired dentist with end-stage heart failure received the first permanent artificial heart in Utah in 1982 his wife of 39 years reportedly asked the doctors

will he still be able to love me

today we know that the heart is not the source of Love or the other emotions per se the Ancients were mistaken and yet more and more we have come to understand that the connection between the heart and the emotions is highly intimate one The Heart may not originate our feelings but it is highly responsive to them in a sense a record of our emotional life is written on our hearts fear and grief for example can cause profound cardiac injury the nerves that control unconscious processes such as the heartbeat can sense distress and trigger a maladaptive fight or flight response that triggers blood vessels to constrict the heart to gallop and blood pressure to rise resulting in damage in other words

it is increasingly clear that our hearts are extraordinarily sensitive to our emotional system to the metaphorical heart if you will there is a heart disorder first recognized about two decades ago called Taco subo cardiomyopathy or the broken heart syndrome in which the heart acutely weakens in response to intense stress or grief such as after a romantic breakup or the death of a loved one The Grieving heart looks very different than the normal heart it appears stunned and frequently balloons into the distinctive shape of a taco subo a Japanese pot with a wide base and a narrow neck we don't know exactly why this happens and the syndrome usually resolves within a few weeks however in the acute period it can cause heart failure life-threatening arrhythmias even death for example the

husband of an elderly patient of mine had died recently

she was sad of course but accepting

maybe even a bit relieved it had been a very long illness he'd had dementia but a week after the funeral she looked at his picture

and became tearful

and then she developed chest pain and with it came shortness of breath distended neck veins a sweaty brow a noticeable panting as she was sitting up in a chair all signs

of heart failure

she was admitted to the hospital where an ultrasound confirmed what we already suspected her heart had weakened to less than half its normal capacity and had ballooned into the distinctive shape of a taco soup oh but no other tests were Miss no sign of clogged arteries anywhere

two weeks later her emotional state had returned to normal and so and ultrasound confirmed had her heart

Taco super cardiomyopathy has been linked to many stressful situations including public speaking

domestic disputes gambling losses even a surprise birthday party it's even been associated with widespread social upheaval such as after a natural disaster for example in 2004 a massive earthquake devastated a district on the largest island in Japan more than 60 people were killed and thousands were injured on the heels of this catastrophe researchers found that the incidence of Taco suppo cardiomyopathy increased twenty four fold in the district one month after the earthquake compared to a similar period the year before

the residences of these cases closely correlated with the intensity of the Tremor in almost every case patients live near the epicenter interestingly Taco super cardiomyopathy has been seen after a happy event too

but the heart appears to react differently ballooning in the mid portion for example and not at the Apex why different emotional precipitants would result in different cardiac changes remains a mystery but today perhaps as an Ode to our ancient philosophers we can say that even if emotions are not contained inside our hearts the emotional heart overlaps it's metaphorical counterpart

it's biological counterpart in surprising and mysterious ways part syndromes

including sudden death have long been reported in individuals experiencing intense emotional disturbance or turmoil in their metaphorical hearts in 1942 the Harvard physiologist Walter Cannon published a paper called Voodoo death in which he described cases of death from Fright in people who believed they had been cursed such as by a witch doctor or as a consequence of eating taboo fruit in many cases the victim all hope lost drop dead on the spot

what these cases had in common was the victims absolute belief that there was external force that could cause their demise and against which they were powerless to fight this perceived lack of control Cannon postulated resulted in an unmitigated physiological response in which blood vessels constricted to such a degree that blood volume acutely dropped blood pressure plummeted the heart acutely weakened and massive organ damage resulted from a lack of transported oxygen

Canon believe that Voodoo deaths

were limited to indigenous or primitive people but over the years these types of deaths have been shown to occur in all manner of modern people to today death by grief has been seen in spouses and in siblings broken hearts are literally and figuratively deadly these associations hold true even for animals

in a fascinating study in 1980 published in the journal science researchers fed caged rabbits a high cholesterol diet to study its effect on cardiovascular disease surprisingly they found that some rabbits develop a lot more disease than others but they couldn't explain why the rabbits had very similar diet environment and genetic makeup they thought it might have something to do with how frequently the technician interacted with the rabbits so they repeated the study dividing the rabbits into two groups both groups were fed a high cholesterol diet

but in one group the rabbits were removed from their cages held petted talk to played with and in the other group the rabbits remained in their cages and were left alone at one year

on autopsy the researchers found that the rabbits

in the first group that received human interaction had sixty percent less aortic disease and rabbits and the other group despite having similar cholesterol levels blood pressure and heart rate today the care of the heart has become less the province of philosophers who dwelled on the hearts metaphorical meanings and more their domain of doctors like me wielding technologies that even a century ago because of the hearts exalted status in human culture were considered Taboo in the process the heart has been transformed from an almost Supernatural object

imbued with metaphor and meaning into a machine that can be manipulated and controlled

but this is the key Point these manipulations We Now understand must be complemented by attention to the emotional life that the heart for thousands of years was believed to contain

consider for example the lifestyle heart trial published in the British Journal the Lancet in 1990 48 patients with moderate or severe coronary disease were randomly assigned to usual care or an intensive lifestyle that included a low-fat vegetarian diet moderate aerobic exercise group psychosocial support and Stress Management advice the researchers found that the lifestyle patients had a nearly 5 percent reduction in coronary plaque control patients on the other hand had 5% more coronary plaque at one year and 28% more and five years they also had nearly double the rate of cardiac events like heart attacks coronary bypass surgery and cardiac related deaths now here's an interesting fact

some patients in the control group adopted diet and exercise plans that were nearly as intense as those in the Intensive lifestyle group

their heart disease still progressed

diet and exercise alone were not enough to facilitate coronary disease regression at both 1 and 5 year follow-ups

Stress Management was more strongly correlated with reversal of coronary disease and exercise was

no doubt this and similar studies are small and of course correlation does not prove causation it's certainly possible that stress leads to unhealthy habits and that's the real reason for the increased cardiovascular risk but as with the association of smoking and lung cancer when so many studies show the same thing and when there are mechanisms to explain a causal relationship it seems capricious to deny that one probably exists what many doctors have concluded is what I too have learned in my nearly two decades as a heart specialist

the emotional heart intersects with its biological counterpart and surprising and mysterious ways and yet medicine today continues to conceptualize the heart as a machine this conceptualization is has had great benefits Cardiology my field is undoubtedly one of the greatest scientific success stories of the past 100 years

Stan's pacemakers defibrillators coronary bypass surgery heart transplants all these things were developed or invented after World War 2 however it's possible that we are approaching the limits of what scientific medicine can do to combat heart disease indeed the rate of decline of cardiovascular mortality has slowed significantly in the past decade

we will need to shift to a new paradigm to continue to make the kind of progress to which we have become accustomed in this Paradigm psychosocial factors will need to be front and center in how we think about heart problems this is going to be an uphill battle and remains a domain that is largely unexplored

the American Heart Association still does not list emotional stress as a key modifiable risk factor for heart disease perhaps in part because blood cholesterol is so much easier to lower than emotional and social disruption

there is a better way perhaps if we recognize that when we say a broken heart

we are indeed sometimes talking about real broken heart we must must pay more attention to the power and importance of the emotions in taking care of our hearts emotional stress I have learned is often a matter of life and death

thank you

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