Confederates in the Attic: Posttraumatic Stress Disorder, Cardiovascular Disease, and the Return of Soldier's Heart

Overview

Journal J Nerv Ment Dis

Specialties Neurology
Psychiatry

Date 2020 Feb 25

PMID 32091470

Citations 2

Authors

J Douglas Bremner

Matthew T Wittbrodt

Amit J Shah

Bradley D Pearce

Nil Z Gurel

Omer T Inan

Paolo Raggi

Tene T Lewis

Arshed A Quyyumi

Viola Vaccarino

Affiliations

Soon will be listed here.

Abstract

Da Costa originally described Soldier's Heart in the 19th Century as a syndrome that occurred on the battlefield in soldiers of the American Civil War. Soldier's Heart involved symptoms similar to modern day posttraumatic stress disorder (PTSD) as well as exaggerated cardiovascular reactivity felt to be related to an abnormality of the heart. Interventions were appropriately focused on the cardiovascular system. With the advent of modern psychoanalysis, psychiatric symptoms became divorced from the body and were relegated to the unconscious. Later, the physiology of PTSD and other psychiatric disorders was conceived as solely residing in the brain. More recently, advances in psychosomatic medicine led to the recognition of mind-body relationships and the involvement of multiple physiological systems in the etiology of disorders, including stress, depression PTSD, and cardiovascular disease, has moved to the fore, and has renewed interest in the validity of the original model of the Soldier's Heart syndrome.

Citing Articles

A Pilot Study of Neurobiological Mechanisms of Stress and Cardiovascular Risk.

Douglas Bremner J, Piccinelli M, Garcia E, Moncayo V, Elon L, Nye J Med Res Arch. 2023; 11(4).

PMID: 37484871 PMC: 10361343. DOI: 10.18103/mra.v11i4.3787.

Estrogen Protects Vasomotor Functions in Rats During Catecholamine Stress.

Zhang L, Li C, Yang L, Adzika G, Ongachwa Machuki J, Shi M Front Cardiovasc Med. 2021; 8:679240.

PMID: 34222374 PMC: 8241912. DOI: 10.3389/fcvm.2021.679240.

References

Gurel N, Huang M, Wittbrodt M, Jung H, Ladd S, Shandhi M . Quantifying acute physiological biomarkers of transcutaneous cervical vagal nerve stimulation in the context of psychological stress. Brain Stimul. 2019; 13(1):47-59. PMC: 8252146. DOI: 10.1016/j.brs.2019.08.002. View

Milad M, Quirk G . Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. 2002; 420(6911):70-4. DOI: 10.1038/nature01138. View

Sareen J, Cox B, Stein M, Afifi T, Fleet C, Asmundson G . Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosom Med. 2007; 69(3):242-8. DOI: 10.1097/PSY.0b013e31803146d8. View

Bremner J, Vythilingam M, Vermetten E, Adil J, Khan S, Nazeer A . Cortisol response to a cognitive stress challenge in posttraumatic stress disorder (PTSD) related to childhood abuse. Psychoneuroendocrinology. 2003; 28(6):733-50. DOI: 10.1016/s0306-4530(02)00067-7. View

Douglas Bremner J, Vythilingam M, Vermetten E, Afzal N, Nazeer A, Newcomer J . Effects of dexamethasone on declarative memory function in posttraumatic stress disorder. Psychiatry Res. 2004; 129(1):1-10. DOI: 10.1016/j.psychres.2004.08.004. View

Yehuda R, Kahana B, Southwick S, Mason J, Giller E . Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder. Am J Psychiatry. 1995; 152(7):982-6. DOI: 10.1176/ajp.152.7.982. View

Yehuda R, Teicher M, Levengood R, Trestman R, Siever L . Circadian regulation of basal cortisol levels in posttraumatic stress disorder. Ann N Y Acad Sci. 1994; 746:378-80. DOI: 10.1111/j.1749-6632.1994.tb39260.x. View

Southwick S, Krystal J, Morgan C, Johnson D, Nagy L, Nicolaou A . Abnormal noradrenergic function in posttraumatic stress disorder. Arch Gen Psychiatry. 1993; 50(4):266-74. DOI: 10.1001/archpsyc.1993.01820160036003. View

Hitchcock J, Sananes C, Davis M . Sensitization of the startle reflex by footshock: blockade by lesions of the central nucleus of the amygdala or its efferent pathway to the brainstem. Behav Neurosci. 1989; 103(3):509-18. DOI: 10.1037//0735-7044.103.3.509. View

10.

Kessler R, Sonnega A, Bromet E, Hughes M, Nelson C . Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995; 52(12):1048-60. DOI: 10.1001/archpsyc.1995.03950240066012. View

11.

Strike P, Steptoe A . Behavioral and emotional triggers of acute coronary syndromes: a systematic review and critique. Psychosom Med. 2005; 67(2):179-86. DOI: 10.1097/01.psy.0000155663.93160.d2. View

12.

Bremner J . Does stress damage the brain?. Biol Psychiatry. 1999; 45(7):797-805. DOI: 10.1016/s0006-3223(99)00009-8. View

13.

Lacy C, Contrada R, ROBBINS M, Tannenbaum A, Moreyra A, Chelton S . Coronary vasoconstriction induced by mental stress (simulated public speaking). Am J Cardiol. 1995; 75(7):503-5. DOI: 10.1016/s0002-9149(99)80590-6. View

14.

Rozanski A, Bairey C, Krantz D, Friedman J, Resser K, Morell M . Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease. N Engl J Med. 1988; 318(16):1005-12. DOI: 10.1056/NEJM198804213181601. View

15.

Lerer B, Bleich A, Bennett E, Ebstein R, Balkin J . Platelet adenylate cyclase and phospholipase C activity in posttraumatic stress disorder. Biol Psychiatry. 1990; 27(7):735-40. DOI: 10.1016/0006-3223(90)90588-s. View

16.

Heim C, Newport D, Heit S, Graham Y, Wilcox M, Bonsall R . Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA. 2000; 284(5):592-7. DOI: 10.1001/jama.284.5.592. View

17.

Phillips R, LeDoux J . Differential contribution of amygdala and hippocampus to cued and contextual fear conditioning. Behav Neurosci. 1992; 106(2):274-85. DOI: 10.1037//0735-7044.106.2.274. View

18.

Evans D, Charney D, Lewis L, Golden R, Gorman J, Krishnan K . Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005; 58(3):175-89. DOI: 10.1016/j.biopsych.2005.05.001. View

19.

Kitayama N, Vaccarino V, Kutner M, Weiss P, Douglas Bremner J . Magnetic resonance imaging (MRI) measurement of hippocampal volume in posttraumatic stress disorder: a meta-analysis. J Affect Disord. 2005; 88(1):79-86. DOI: 10.1016/j.jad.2005.05.014. View

20.

Lemieux A, Coe C . Abuse-related posttraumatic stress disorder: evidence for chronic neuroendocrine activation in women. Psychosom Med. 1995; 57(2):105-15. DOI: 10.1097/00006842-199503000-00002. View