Music and the Heart
A few weeks ago, we placed a pacemaker in an elderly cowboy who’s spent most of his life working, and very little time with a doctor.
He told me right before we started, “I hate to admit it, but I’m really nervous. Please don’t tell anyone.”
I asked what his favorite music was, and, not surprisingly, he named a number of classic country singers. The next thing he heard was, “Hello, my name is Johnny Cash.”
We gave him sedation, so he doesn’t remember a lot of the heart procedure, but the first thing he said in the recovery unit was, “I sure like John Cash.”
It’s amazing to me that, with the combination of fear, stress, and anesthesia, the mind held on to music, which brought comfort.
Music Is for the Body and Mind
I don’t really play an instrument well, and if I don’t have someone next to me who can keep me in tune, people can confuse my singing with an elk’s call. Despite my own talent deficiencies, I really appreciate those who are musically gifted. I’ve had music with me at all times since I was able to buy a Sony Walkman and my first cassette tape as a kid — back when music first became a carry-along companion.
Music can provide peace and happiness, and can be uplifting. It can give you the extra motivation you need to run another mile or lift another set of weights. Music can prepare you mentally before a challenge, give a rhythm to dance to, or just provide hours of entertainment. I think that for many of us, music is ingrained in our lives.
Since this is a heart column, the natural question is: What does music do to the heart that can reduce disease and hopefully improve long-term health and longevity? The effect of music on the heart was the topic of a September 2015 review article in the European Heart Journal that highlights the value of music in the prevention and treatment of heart disease.
Music Influences Our Body Consciously and Unconsciously
Our bodies and minds recognize the presence of music immediately. When people listen to music, their heart rate increases compared to those who remain in silence. The increase may be very small when listening to calming, peaceful music, or quite high when listening to exciting music. The beat seems to integrate itself into our subconscious minds, and our heart responds. We even breathe slightly more rapidlywhen we’re initially exposed to all kinds of music.
When we enjoy music, the effect can be measured in the heart no matter what type of music it is. Normally, our hearts are continually being stimulated and relaxed. The sympathetic (adrenalin-mediated) nervous system raises our heart rate and the contractility, or squeeze, of the heart, while the parasympathetic nervous system slows the heart and helps it relax. Music can shift the autonomic balance of the heart and the influence of these two nervous systems in a healthy manner.
For me, listening to heavy metal doesn’t provide feelings of calm, tranquility, and peace. I don’t mind this type of music, because it’s what we listened to when exercising during high school. But for a heavy metal enthusiast, listening to heavy metal can be calming, healthy, and helpful. It’s not the type of music that you like that’s important, but how it makes you feel. The stress reduction in enjoying music can be measured directly as they develop a healthier immune system and release less stress-related hormones, like cortisol.
Music Relieves Anxiety Over Heart Procedures
People who live with heart disease typically have higher levels of anxiety. In fact, with some abnormal heart rhythms, anxiety is the primary symptom, along with palpitations. When people who have heart disease listen to music over time, their heart rates and blood pressure levels may decrease.
Listening to music while undergoing heart procedures, like a catheterization used to treat atrial fibrillation, lowers feelings of stress, anxiety, and pain associated with the procedure. I often take advantage of this natural response to music for my heart patients. We ask patients what their favorite music is, and play it during procedures when they require mild sedation. For many patients, music takes the edge off.
Music Can Lower Blood Pressure
It may not be surprising to you that music can lower blood pressure, which rises naturally with stress. Some of the reduction in blood pressure with music exposure likely relates to the fact that it lowers anxiety, as discussed above. But in people suffering from high blood pressure, it can be used directly to lower blood pressure. In patients suffering from high blood pressure, research shows that as music begins to influence the body, the respiratory rate slows, breaths become deeper, and blood pressure is reduced.
Music Provides Pain Relief
Many of the pain medications we use after a heart procedure bind to small receptors in the brain to lower the sensation of pain. Our strongest pain medications, narcotics, work through the brain’s opioid receptors and through the release of oxytocin. Even during painful procedures like open-heart surgery, music can increase the natural release of oxytocin and provide pain relief. In patients with coronary heart disease, listening to music alone can result in a small-to-moderate pain reduction from their heart condition. Music can even reduce pain in people who are facing the physical and emotion toll of battling cancer.
Depression Responds to Music Therapy
As a physician who treats heart disease on a daily basis, I see one problem that frequently goes unrecognized or untreated: People with heart disease often suffer from depression. The two conditions go hand-in-hand, and can worsen one another. People who have depression are nearly twice as likely to develop heart disease, and people who have heart disease and develop depression are more likely to experience a stroke, heart failure, atrial fibrillation, or a heart attack. Music that is perceived as calming, pleasant, and uplifting can be used to help treat depression. Although music therapy has never been fully studied to treat depression in people with heart disease, the studies that have shown benefit with other diseases, such as Crohn’s disease and depression, suggest that this should be studied.
Music Works With the Body’s Natural Rhythm
Music is an integral part of our lives. Our bodies, and in particular our hearts, respond to it on a fundamental level even when we don’t fully recognize it. When we’re exposed to music that we perceive as calming and peaceful, this exposure can lower the heart rate, blood pressure, and depression; minimize the effect of anxiety on the heart; and both lower the pain response and improve pain tolerance.