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

• Type of Material: Article
• Authors: James Bremner, Emory University; Matthew T Wittbrodt, Emory University; Amit Shah, Emory University; Bradley Pearce, Emory University; Nilb Z Gurel, Georgia Institute of Technology; Omer T Inan, Georgia Institute of Technology; Paolo Raggi, Emory University; Tene Lewis, Emory University; Arshed Quyyumi, Emory University; Laura Vaccarino, Emory University
• Language: English
• Date: 2020-03-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Wolters Kluwer Health, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/NMD.0000000000001100
• Title of Journal or Parent Work: JOURNAL OF NERVOUS AND MENTAL DISEASE
• Volume: 208
• Issue: 3
• Start Page: 171
• End Page: 180
• Grant/Funding Information: The work presented in this review was supported by grants from the NIH R01 MH056120, R01 HL088726, K24 MH076955, P01 HL101398, T32 MH067547, K24 HL077506, R01 HL068630, R01 HL109413, K23 HL127251, R01 HL125246, S10 RR16917, DARPA Cooperative Agreement N66001-16-2-4054, the Department of Veterans Affairs, and the University of Alberta Research Fund.
• Keywords: COMBAT VETERANS; Psychiatry; myocardial ischemia; depression; Neurosciences & Neurology; CONDITIONED FEAR; Clinical Neurology; depressive disorders; FEAR-POTENTIATED STARTLE; LEFT-VENTRICULAR DYSFUNCTION; child development disorders; Science & Technology; child development; MEDIAL PREFRONTAL CORTEX; pervasive; ADVERSE CHILDHOOD EXPERIENCES; coronary artery disease; major depression; MENTAL STRESS; Posttraumatic stress disorders; child abuse; INDUCED-MYOCARDIAL-ISCHEMIA; Life Sciences & Biomedicine; cardiovascular disease; CORTICOTROPIN-RELEASING-FACTOR; dissociative disorders; ACUTE CORONARY SYNDROMES; stress; neurobiology

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.