Psychophysiologic control mechanisms in ischemic heart disease: the mind-heart connection

The cardiovascular system is a unified, dynamic, constantly responding system. Adjustments are made in response to local metabolic factors, systemic physiologic factors, or peripheral and central nervous system factors. This article focuses on the interactions of the cardiovascular system with the peripheral and central nervous system. Since activation of the sympathetic branch of the autonomic nervous system appears to play an important role in cardiovascular physiology and pathophysiology, a more detailed description of this system appears. Using Engel's Biopsychosocial Model of Health and Disease, the impact of the mind and emotions on cardiovascular behavior and health is emphasized. Several key nursing interventions that have been shown to impact favorably on mind-heart interactions are highlighted.