Psychogenic heart disease—stress and the heart: a historical perspective

Although ‘stress’ is accepted by the general population and patients with cardiac disease as a contributor to acute cardiac events and to the disease itself, this has not been universally accepted by the scientific community over the last century. Historically, research is not always helpful because it is unclear whether what is being researched is the cause of the cardiac event (e.g. myocardial infarction) or the underlying disease. A great deal of effort had been put into researching the concept of the coronary prone personality (i.e. Type A) with somewhat modest results. The shift in focus to the involvement of negative affect in cardiac disease has moved the field forward significantly. Recently, research has furthered our understanding of the mechanisms whereby stressful life experiences may interact with predispositions to experience the negative affects of anxiety, anger and depression (i.e. a feature of personality) and inherited cardiac disease proneness to result in both disease and acute events.