CIRCULATORY DYNAMICS BEFORE AND AFTER EXERCISE IN SUBJECTS WITH AND WITHOUT STRUCTURAL HEART DISEASE DURING ANXIETY AND RELAXATION 1

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Abstract
A study was made of heart rate, blood pressure, and cardiac output before and after a standard exercise test in subjects with and without structural heart disease who gave evidence of various degrees of emotional disturbance. The avg. cardiac outputs of subjects who were slightly disturbed emotionally were greater before and after exercise than those of subjects who were apparently relaxed. The difference was largely attributable to increase in stroke vol. The avg. cardiac outputs of subjects with marked, overt anxiety showed avg. cardiac outputs before and after exercise greater than those of the poorly relaxed subjects. The difference was largely attributable to greater increases in heart rate. In general, there was a close correlation between symptoms such as dyspnea, palpitations and weakness on exertion and impaired exercise tolerance. In 10 subjects with structural heart disease studied similarly, the same relationship was found between emotional disturbances and the occurrence of symptoms and signs of effort intolerance. The symptoms themselves were similar to those associated with cardiac failure. Changes in the emotional state were accompanied by changes in exercise tolerance and in seven instances $uch alterations in exercise tolerance were observed in less than an hr.