Heart Scare, Heart Surveys, and Iatrogenic Heart Disease

One hundred sixty-two individuals who, as a result of a chest x-ray examination made during the course of a tuberculosis survey, were informed that there might be something wrong with their heart were questioned to see if the suggestion that one has heart disease leads to the development of heart symptoms or symptoms of "neuroses." It is not surprising to find persons upset by this procedure, but it is of interest to find that symptoms did not develop to any extent except in persons with preexisting neurocirculatory asthenia. There was no evidence that this procedure precipitated neurocirculatory asthenia (anxiety neurosis, cardiac neurosis, neurasthenia, effort syndrome). These individuals are not necessarily a representative sample of the general population or of patients seen in doctors' offices. The relation of the findings of this study to the concept of iatrogenic heart disease is examined.