Psychosomatic Medicine 11:257-272 (1949)
© 1949 American Psychosomatic Society

Life Situations, Emotions, and Extrasystoles

¹ New York Hospital and the Departments of Medicine and Psychiatry of Cornell University Medical College, New York, N.Y.

In a group of 12 unselected patients with extrasystoles, the life situation and emotional state of the patient were found to be relevant to the occurrence of the arrhythmias in each patient.

Extrasystoles and associated anxiety were observed in these subjects experimentally during a discussion of topics to which they were known to be sensitive or which had previously been associated with extrasystoles.

The excitability of the heart may be significantly altered by prolonged hyperactivity of the cardiac muscle during anxiety with tachycardia and increased stroke volume. Structurally diseased hearts are less able to stand the strain of such hyperactivity and more readily develop an altered excitability than do normal hearts. Extrasystoles are therefore particularly common in patients with structural heart disease who exhibit prolonged anxiety and the associated reaction of cardiac mobilization.

The treatment of subjects with extrasystoles should include attention to the life situation and the patient's adjustment to it, not only for its effect on the arrhythmia but in relieving the stress on the heart, of which the extrasystoles are an indication.