How your emotions change the shape of your heart
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0:01 - 0:03No other organ,
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0:03 - 0:07perhaps no other object in human life,
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0:07 - 0:11is as imbued with metaphor
and meaning as the human heart. -
0:11 - 0:13Over the course of history,
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0:13 - 0:16the heart has been a symbol
of our emotional lives. -
0:17 - 0:21It was considered by many
to be the seat of the soul, -
0:21 - 0:23the repository of the emotions.
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0:23 - 0:30The very word "emotion" stems in part
from the French verb "émouvoir," -
0:30 - 0:32meaning "to stir up."
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0:32 - 0:37And perhaps it's only logical
that emotions would be linked to an organ -
0:37 - 0:39characterized by its agitated movement.
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0:40 - 0:41But what is this link?
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0:41 - 0:45Is it real or purely metaphorical?
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0:45 - 0:47As a heart specialist,
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0:47 - 0:53I am here today to tell you
that this link is very real. -
0:53 - 0:55Emotions, you will learn,
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0:55 - 1:01can and do have a direct
physical effect on the human heart. -
1:02 - 1:04But before we get into this,
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1:04 - 1:06let's talk a bit about
the metaphorical heart. -
1:07 - 1:11The symbolism of the emotional heart
endures even today. -
1:11 - 1:17If we ask people which image
they most associate with love, -
1:17 - 1:21there's no question that the Valentine
heart would the top the list. -
1:22 - 1:25The heart shape, called a cardioid,
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1:25 - 1:26is common in nature.
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1:27 - 1:31It's found in the leaves,
flowers and seeds of many plants, -
1:31 - 1:33including silphium,
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1:33 - 1:37which was used for birth control
in the Middle Ages -
1:37 - 1:40and perhaps is the reason why
the heart became associated -
1:40 - 1:43with sex and romantic love.
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1:44 - 1:45Whatever the reason,
-
1:45 - 1:50hearts began to appear in paintings
of lovers in the 13th century. -
1:50 - 1:54Over time, the pictures
came to be colored red, -
1:54 - 1:56the color of blood,
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1:56 - 1:57a symbol of passion.
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1:58 - 2:00In the Roman Catholic Church,
-
2:00 - 2:04the heart shape became known
as the Sacred Heart of Jesus. -
2:05 - 2:08Adorned with thorns
and emitting ethereal light, -
2:08 - 2:12it became an insignia of monastic love.
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2:12 - 2:17This association between the heart
and love has withstood modernity. -
2:17 - 2:22When Barney Clark, a retired dentist
with end-stage heart failure, -
2:22 - 2:28received the first permanent
artificial heart in Utah in 1982, -
2:28 - 2:33his wife of 39 years
reportedly asked the doctors, -
2:34 - 2:36"Will he still be able to love me?"
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2:37 - 2:40Today, we know that the heart
is not the source of love -
2:40 - 2:42or the other emotions, per se;
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2:42 - 2:44the ancients were mistaken.
-
2:44 - 2:46And yet, more and more,
we have come to understand -
2:47 - 2:51that the connection between the heart
and the emotions is a highly intimate one. -
2:51 - 2:54The heart may not originate our feelings,
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2:54 - 2:56but it is highly responsive to them.
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2:56 - 2:59In a sense, a record of our emotional life
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2:59 - 3:01is written on our hearts.
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3:02 - 3:07Fear and grief, for example,
can cause profound cardiac injury. -
3:07 - 3:11The nerves that control unconscious
processes such as the heartbeat -
3:11 - 3:13can sense distress
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3:13 - 3:18and trigger a maladaptive
fight-or-flight response -
3:18 - 3:22that triggers blood vessels to constrict,
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3:22 - 3:23the heart to gallop
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3:23 - 3:26and blood pressure to rise,
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3:26 - 3:28resulting in damage.
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3:28 - 3:29In other words,
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3:29 - 3:32it is increasingly clear
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3:32 - 3:37that our hearts are extraordinarily
sensitive to our emotional system, -
3:37 - 3:40to the metaphorical heart, if you will.
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3:40 - 3:45There is a heart disorder
first recognized about two decades ago -
3:45 - 3:50called "takotsubo cardiomyopathy,"
or "the broken heart syndrome," -
3:50 - 3:56in which the heart acutely weakens
in response to intense stress or grief, -
3:56 - 4:00such as after a romantic breakup
or the death of a loved one. -
4:00 - 4:04As these pictures show,
the grieving heart in the middle -
4:04 - 4:07looks very different
than the normal heart on the left. -
4:07 - 4:08It appears stunned
-
4:08 - 4:13and frequently balloons into
the distinctive shape of a takotsubo, -
4:13 - 4:14shown on the right,
-
4:14 - 4:18a Japanese pot with a wide base
and a narrow neck. -
4:18 - 4:21We don't know exactly why this happens,
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4:21 - 4:23and the syndrome usually resolves
within a few weeks. -
4:24 - 4:25However, in the acute period,
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4:26 - 4:28it can cause heart failure,
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4:28 - 4:30life-threatening arrhythmias,
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4:30 - 4:32even death.
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4:32 - 4:37For example, the husband
of an elderly patient of mine -
4:37 - 4:39had died recently.
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4:39 - 4:43She was sad, of course, but accepting.
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4:44 - 4:45Maybe even a bit relieved.
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4:45 - 4:48It had been a very long illness;
he'd had dementia. -
4:48 - 4:52But a week after the funeral,
she looked at his picture -
4:52 - 4:54and became tearful.
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4:55 - 5:00And then she developed chest pain,
and with it, came shortness of breath, -
5:00 - 5:03distended neck veins, a sweaty brow,
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5:03 - 5:06a noticeable panting
as she was sitting up in a chair -- -
5:06 - 5:10all signs of heart failure.
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5:11 - 5:13She was admitted to the hospital,
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5:14 - 5:18where an ultrasound confirmed
what we already suspected: -
5:18 - 5:24her heart had weakened
to less than half its normal capacity -
5:24 - 5:29and had ballooned into
the distinctive shape of a takotsubo. -
5:29 - 5:31But no other tests were amiss,
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5:31 - 5:33no sign of clogged arteries anywhere.
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5:34 - 5:39Two weeks later, her emotional state
had returned to normal -
5:39 - 5:43and so, an ultrasound confirmed,
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5:43 - 5:44had her heart.
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5:45 - 5:51Takotsubo cardiomyopathy has been linked
to many stressful situations, -
5:51 - 5:53including public speaking --
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5:53 - 5:56(Laughter)
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5:59 - 6:03(Applause)
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6:05 - 6:08domestic disputes, gambling losses,
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6:08 - 6:10even a surprise birthday party.
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6:10 - 6:12(Laughter)
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6:12 - 6:16It's even been associated
with widespread social upheaval, -
6:16 - 6:19such as after a natural disaster.
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6:19 - 6:21For example, in 2004,
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6:21 - 6:27a massive earthquake devastated a district
on the largest island in Japan. -
6:27 - 6:31More than 60 people were killed,
and thousands were injured. -
6:31 - 6:34On the heels of this catastrophe,
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6:34 - 6:39researchers found that the incidents
of takotsubo cardiomyopathy -
6:39 - 6:44increased twenty-four-fold in the district
one month after the earthquake, -
6:44 - 6:47compared to a similar
period the year before. -
6:48 - 6:51The residences of these cases
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6:51 - 6:54closely correlated with
the intensity of the tremor. -
6:54 - 6:58In almost every case,
patients lived near the epicenter. -
6:59 - 7:05Interestingly, takotsubo cardiomyopathy
has been seen after a happy event, too, -
7:05 - 7:08but the heart appears
to react differently, -
7:08 - 7:12ballooning in the midportion,
for example, and not at the apex. -
7:12 - 7:18Why different emotional precipitants
would result in different cardiac changes -
7:18 - 7:19remains a mystery.
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7:20 - 7:24But today, perhaps as an ode
to our ancient philosophers, -
7:24 - 7:30we can say that even if emotions
are not contained inside our hearts, -
7:30 - 7:35the emotional heart overlaps
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7:37 - 7:39its biological counterpart,
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7:39 - 7:42in surprising and mysterious ways.
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7:43 - 7:47Heart syndromes, including sudden death,
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7:47 - 7:52have long been reported in individuals
experiencing intense emotional disturbance -
7:52 - 7:54or turmoil in their metaphorical hearts.
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7:55 - 7:57In 1942,
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7:57 - 8:02the Harvard physiologist Walter Cannon
published a paper called "'Voodoo' Death," -
8:02 - 8:06in which he described
cases of death from fright -
8:06 - 8:08in people who believed
they had been cursed, -
8:08 - 8:13such as by a witch doctor
or as a consequence of eating taboo fruit. -
8:13 - 8:18In many cases, the victim, all hope lost,
dropped dead on the spot. -
8:19 - 8:24What these cases had in common
was the victim's absolute belief -
8:24 - 8:27that there was an external force
that could cause their demise, -
8:27 - 8:30and against which
they were powerless to fight. -
8:30 - 8:34This perceived lack of control,
Cannon postulated, -
8:34 - 8:37resulted in an unmitigated
physiological response, -
8:37 - 8:41in which blood vessels
constricted to such a degree -
8:42 - 8:45that blood volume acutely dropped,
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8:45 - 8:46blood pressure plummeted,
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8:46 - 8:48the heart acutely weakened,
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8:48 - 8:52and massive organ damage resulted
from a lack of transported oxygen. -
8:54 - 8:56Cannon believed that voodoo deaths
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8:57 - 9:01were limited to indigenous
or "primitive" people. -
9:02 - 9:06But over the years, these types of deaths
have been shown to occur -
9:06 - 9:09in all manner of modern people, too.
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9:10 - 9:16Today, death by grief has been seen
in spouses and in siblings. -
9:16 - 9:20Broken hearts are literally
and figuratively deadly. -
9:21 - 9:24These associations hold true
even for animals. -
9:25 - 9:31In a fascinating study in 1980
published in the journal "Science," -
9:31 - 9:35researchers fed caged rabbits
a high-cholesterol diet -
9:35 - 9:38to study its effect
on cardiovascular disease. -
9:39 - 9:44Surprisingly, they found that some rabbits
developed a lot more disease than others, -
9:44 - 9:46but they couldn't explain why.
-
9:46 - 9:52The rabbits had very similar diet,
environment and genetic makeup. -
9:52 - 9:54They thought it might have
something to do with -
9:54 - 9:58how frequently the technician
interacted with the rabbits. -
9:58 - 10:00So they repeated the study,
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10:00 - 10:03dividing the rabbits into two groups.
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10:03 - 10:05Both groups were fed
a high-cholesterol diet. -
10:06 - 10:10But in one group, the rabbits
were removed from their cages, -
10:10 - 10:14held, petted, talked to, played with,
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10:14 - 10:17and in the other group,
the rabbits remained in their cages -
10:17 - 10:19and were left alone.
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10:19 - 10:23At one year, on autopsy,
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10:23 - 10:28the researchers found
that the rabbits in the first group, -
10:28 - 10:30that received human interaction,
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10:30 - 10:36had 60 percent less aortic disease
than rabbits in the other group, -
10:36 - 10:41despite having similar cholesterol levels,
blood pressure and heart rate. -
10:42 - 10:48Today, the care of the heart has become
less the province of philosophers, -
10:48 - 10:53who dwell upon the heart's
metaphorical meanings, -
10:53 - 10:57and more the domain of doctors like me,
-
10:57 - 10:59wielding technologies
that even a century ago, -
10:59 - 11:02because of the heart's exalted
status in human culture, -
11:03 - 11:04were considered taboo.
-
11:04 - 11:08In the process, the heart
has been transformed -
11:08 - 11:14from an almost supernatural object
imbued with metaphor and meaning -
11:14 - 11:18into a machine that can be
manipulated and controlled. -
11:19 - 11:21But this is the key point:
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11:21 - 11:25these manipulations, we now understand,
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11:25 - 11:29must be complemented
by attention to the emotional life -
11:30 - 11:33that the heart, for thousands of years,
was believed to contain. -
11:34 - 11:37Consider, for example,
the Lifestyle Heart Trial, -
11:37 - 11:42published in the British journal
"The Lancet" in 1990. -
11:42 - 11:46Forty-eight patients with moderate
or severe coronary disease -
11:46 - 11:49were randomly assigned to usual care
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11:49 - 11:54or an intensive lifestyle
that included a low-fat vegetarian diet, -
11:54 - 11:56moderate aerobic exercise,
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11:56 - 11:58group psychosocial support
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11:58 - 12:00and stress management advice.
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12:00 - 12:04The researchers found
that the lifestyle patients -
12:04 - 12:10had a nearly five percent reduction
in coronary plaque. -
12:10 - 12:12Control patients, on the other hand,
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12:12 - 12:16had five percent more
coronary plaque at one year -
12:16 - 12:19and 28 percent more at five years.
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12:19 - 12:23They also had nearly double
the rate of cardiac events, -
12:23 - 12:26like heart attacks,
coronary bypass surgery -
12:26 - 12:28and cardiac-related deaths.
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12:28 - 12:30Now, here's an interesting fact:
-
12:31 - 12:36some patients in the control group
adopted diet and exercise plans -
12:36 - 12:40that were nearly as intense
as those in the intensive lifestyle group. -
12:41 - 12:43Their heart disease still progressed.
-
12:45 - 12:50Diet and exercise alone were not enough
to facilitate coronary disease regression. -
12:51 - 12:54At both one- and five-year follow-ups,
-
12:55 - 12:57stress management
was more strongly correlated -
12:58 - 13:00with reversal of coronary disease
-
13:00 - 13:01than exercise was.
-
13:02 - 13:06No doubt, this and similar
studies are small, -
13:06 - 13:09and, of course, correlation
does not prove causation. -
13:09 - 13:13It's certainly possible that stress
leads to unhealthy habits, -
13:13 - 13:17and that's the real reason
for the increased cardiovascular risk. -
13:17 - 13:20But as with the association
of smoking and lung cancer, -
13:20 - 13:23when so many studies show the same thing,
-
13:23 - 13:27and when there are mechanisms
to explain a causal relationship, -
13:27 - 13:31it seems capricious to deny
that one probably exists. -
13:32 - 13:35What many doctors have concluded
is what I, too, have learned -
13:36 - 13:38in my nearly two decades
as a heart specialist: -
13:39 - 13:43the emotional heart intersects
with its biological counterpart -
13:43 - 13:46in surprising and mysterious ways.
-
13:46 - 13:51And yet, medicine today continues
to conceptualize the heart as a machine. -
13:51 - 13:54This conceptualization
has had great benefits. -
13:55 - 13:58Cardiology, my field,
-
13:58 - 14:02is undoubtedly one of the greatest
scientific success stories -
14:02 - 14:04of the past 100 years.
-
14:05 - 14:11Stents, pacemakers, defibrillators,
coronary bypass surgery, -
14:11 - 14:12heart transplants --
-
14:12 - 14:16all these things were developed
or invented after World War II. -
14:16 - 14:18However, it's possible
-
14:18 - 14:24that we are approaching the limits
of what scientific medicine can do -
14:24 - 14:25to combat heart disease.
-
14:25 - 14:29Indeed, the rate of decline
of cardiovascular mortality -
14:29 - 14:32has slowed significantly
in the past decade. -
14:33 - 14:36We will need to shift to a new paradigm
-
14:36 - 14:40to continue to make the kind of progress
to which we have become accustomed. -
14:40 - 14:46In this paradigm, psychosocial factors
will need to be front and center -
14:46 - 14:48in how we think about heart problems.
-
14:49 - 14:51This is going to be an uphill battle,
-
14:51 - 14:55and it remains a domain
that is largely unexplored. -
14:56 - 15:01The American Heart Association
still does not list emotional stress -
15:01 - 15:05as a key modifiable risk factor
for heart disease, -
15:05 - 15:10perhaps in part because blood cholesterol
is so much easier to lower -
15:10 - 15:12than emotional and social disruption.
-
15:14 - 15:16There is a better way, perhaps,
-
15:16 - 15:21if we recognize that when
we say "a broken heart," -
15:21 - 15:26we are indeed sometimes talking
about a real broken heart. -
15:26 - 15:32We must, must pay more attention to
the power and importance of the emotions -
15:32 - 15:34in taking care of our hearts.
-
15:34 - 15:37Emotional stress, I have learned,
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15:37 - 15:40is often a matter of life and death.
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15:41 - 15:42Thank you.
-
15:42 - 15:48(Applause)
- Title:
- How your emotions change the shape of your heart
- Speaker:
- Sandeep Jauhar
- Description:
-
"A record of our emotional life is written on our hearts," says cardiologist and author Sandeep Jauhar. In a stunning talk, he explores the mysterious ways our emotions impact the health of our hearts -- causing them to change shape in response to grief or fear, to literally break in response to emotional heartbreak -- and calls for a shift in how we care for our most vital organ.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 16:02
Brian Greene edited English subtitles for How your emotions change the shape of your heart | ||
Brian Greene edited English subtitles for How your emotions change the shape of your heart | ||
Oliver Friedman approved English subtitles for How your emotions change the shape of your heart | ||
Oliver Friedman edited English subtitles for How your emotions change the shape of your heart | ||
Camille Martínez accepted English subtitles for How your emotions change the shape of your heart | ||
Camille Martínez edited English subtitles for How your emotions change the shape of your heart | ||
Camille Martínez edited English subtitles for How your emotions change the shape of your heart | ||
Joseph Geni edited English subtitles for How your emotions change the shape of your heart |