Chest pain, palpitations, shortness of breath and fainting are warning symptoms of a possible life-threatening heart problem. Complaints that really deserve the full attention and care of doctors.
But here's something to think about: Do we pay the same attention to people's minds? The symptoms described above exist in many mental disorders. There are cases of depression that cause chest pain, there is anxiety that causes shortness of breath and palpitation and many psychogenic syndromes cause fainting.
People with heart problems are more likely to develop mental disorders such as depression, anxiety, panic and even post-traumatic stress, and people with these mental disorders are more likely to get heart disease.
What's more, did you know that the way your personality works influences your heart health? People with very aggressive or nervous traits (Type A personality) and those who have a lot of negative feelings but inhibit their expression (Type D personality) are more likely to develop coronary heart disease, stroke and even arrhythmias?
It's common to hear someone say, "I've got a pain in my chest from all the emotion", "he died of grief", "he got scared and never woke up", etc. Recently, I even remember an athlete's father dying of a "massive heart attack" when he watched on television as his daughter won Brazil's first silver medal at the World Para table tennis championships. Did she die of her head or her heart? The right answer is always both.
Heart and mind are connected by the Autonomic Nervous System (ANS), which balances between the sympathetic and parasympathetic nervous systems. Messages go from the breath, heart and other areas of the body to the brain and vice versa.
The truth is that you can't separate mental health from heart health. Both go hand in hand - if one isn't good, the other won't be either. For example, one of the biological stress markers of physical and mental health is heart rate variability (HRV), which measures the tone of the ANS, the gold standard for which is the 24-hour Holter monitor. People with heart problems can have altered/decreased HRV, as can people with mental disorders.
What can we say about cardiovascular risk in patients who have a chronic heart disease associated with depression? What about their quality of life? Furthermore, how can we guarantee that a depressed person will be motivated enough to change their lifestyle and adhere adequately to the proposed cardiac treatment?
The answers to the above questions involve an integrative medical approach. Why can a cardiologist overlook a mental disorder? Why can a psychiatrist neglect an underlying heart disease?
There is a mismatch in medicine that was produced by Descartes when he philosophically separated body and mind by declaring "I think, therefore I am" in 1633. We are still navigating this misunderstanding today.
But, intelligent as we are and inspired by the fantastic neuroscientist António Damásio in "Descartes' Error, Emotion, Reason and the Human Brain", 1994, we can think, review, learn and correct behaviors that we once held to be true.
Why can't we use the traditional electrophysiological diagnostic methods for investigating heart problems, such as Holter monitoring, to try to find out if there is an underlying mental health problem?
Chest pain, palpitations, shortness of breath and fainting are all cardiac and/or psychiatric complaints. Most of the time, the diagnoses coexist and could be noticed early on, at a single moment.
What do you mean?
We can combine technology, artificial intelligence and clinical knowledge to find the solution. In my mind and in my studies, this will be possible with the technology we have developed at Quoretech.
What can the electrocardiographic tracing captured by our new Holter/Looper technique tell us about mental health? Can we identify cases of depression, anxiety and other psychiatric problems in patients suffering from heart disease who have the QuoreOne device on their chest?
I think so! We are evolving in terms of technology and studies - everything seems quite feasible to me. If we succeed, we'll be able to tackle, in one fell swoop, the two groups of diseases (mental and cardiovascular) that cause the most morbidity and mortality in the world.
Unfortunately, Descartes will no longer be here to witness this reintegration of body and mind. In all likelihood, for the sake of health, it's only a matter of time before we doctors, patients and Damasio himself witness this reality.
