Heart and Mind

Although it has been proposed in scholarly works for centuries that psychological factors play a role in the pathophysiology of somatic disease, this belief has not been validated mechanistically until relatively recently. This article discusses one specific instance of this general phenomenon: psycho-cardiology. Combining insights from epidemiological research, which has been prolific in showing associations between cardiovascular and psychological diseases, and the basic science research that has recently begun elucidating the biological mechanisms that may underlie those associations, the aim of this article is to provide a broad overview of the field of psycho-cardiology as it is presently understood. Beginning with a history of the development of psycho-cardiology, the article proceeds through separate sections that discuss contemporary research in the field under the following categories: epidemiology, clinical manifestations, structural and functional derangements, induction mechanisms, the impact of technological and diagnostic changes, and the practical implications for treatment. Taken together, the body of work that this article surveys points clearly to the need to integrate the evaluation for and treatment of psychological disease into the scope of clinical cardiology.