When the Heart Hurts: Pain Perception and Cardiovascular Control

Abstract

The relationship between the sensation of pain and cardiovascular system has been investigated only over the past decades, highlighting significant connections between various areas of our central nervous system and the heart, putting such organs at a very close distance. The nociceptive pathways lead painful stimuli across the nervous system to specifically designated areas, involving the phenomena of transduction, transmission, perception, and modulation. The autonomic response to pain is able to determine a series of systemic effects, and the cardiovascular system is primarily involved, through the rise in heart rate (HR), arterial blood pressure (BP), together with respiratory rate and muscle tension. Acute postoperative pain is a good example of how powerful stimuli, if not properly treated, may seriously affect the whole organism, leading in the end to increased cardiac workload and potentially lethal imbalance between oxygen demand and supply. This becomes even more evident in case patients become chronically exposed to pain. The positive impact of analgesia on cardiovascular control, finally, indicates that this heart-brain relationship is real and can be a therapeutic target in order to improve not only the patients’ symptoms but also their cardiovascular health.