Heartfelt with Dr Melissa Walton-ShirleyView all posts »
Beethoven or Brooks and Dunn? Music is therapy for ACS patientsSep 6, 2009 09:17 EDT
Is music therapy really effective at lowering BP, heart rate, event rates, and even the incidence of sudden cardiac death? Apparently, the answer is yes. Based on a seven-year study of several hundred patients with ACS performed by Dr Mitrovic at the University of Belgrade, in Serbia, we should be taking advantage of a readily available and inexpensive resource to improve outcomes following revascularization.
This isn't the first time we've heard this in theory. At the AHA last year, we reported a small but fascinating study where favorite music (usually country music) produced a 26% improvement in vasodilatation, with a p value of 0.0002, whereas laughter induced by a humorous video produced slightly less impressive but beneficial results as well.
Anxiety-producing music, usually heavy metal, caused a 6% increase in vasoconstriction, with a p value of 0.005. In Dr Mitrovic's study, the preferred music was usually classical music. For our own consideration, we must respect a cultural bias that leads to individual preferences with regard to positive effects on vasodilatation. We must carefully acknowledge that a handful of studies all indict heavy metal music as producing adverse effects. Imagine what smoking a cigarette while listening to AC/DC could do for your freshly wired LAD in the recovery area post-PCI?
I encountered my first interface of music and medicine in 1985. I was assigned the pediatric oncology rotation, and on my first day, a young preteen came for yet another bone-marrow aspiration and biopsy. Though I don't recall her diagnosis, I do recall her headphones. I can see her now as she assumed the prone position, headphones in place, with music escaping around the earpieces. I remember how her body arched just slightly at the exact moment the thick red marrow appeared in the syringe. After it was done, she waited the appropriate amount of "down time," then removed her headphones, placed them neatly in her backpack, and headed out the door smiling, with a return appointment for another procedure. Regardless of her young age, there was no weeping or gnashing of teeth. I don't even recall her parents being in the room with her. I was amazed.
We should not be surprised, though. Great philosophers, musicians, writers, and even scientists such as Einstein understood the link between music and well-being. Confucius said that "music produces a kind of pleasure the soul cannot do without." Conversely, other historical figures understood the adverse effects of "bad" music. Pietro Mascagni, a noted Italian opera composer (1863-1945) said, "Modern Music is as dangerous as cocaine"; not a bad observation, considering flow-mediated dilatation measurements weren't something you could just sign up for back then.
In my personal life, music has been pervasive. My Irish ancestors emigrated from County Limerick, the town of Ballingarry, and immediately formed a band they called "The Berry Pickers," Apparently, it was an instant hit with their neighbors, who gathered in a hay barn every Saturday evening to toe-tapping music produced by fiddles, guitars, and who knows what else. I was told of the death of my great-aunt Anna Liza who died at the age of 17 from what is now thought to have been cystic fibrosis. As she lay dying, she took her favorite ring and placed it on the finger of her youngest sibling, my grandmother. She then weakly reached for her violin to comfort herself one last time. As my grandmother would tell me this story, she said she could still hear "Somewhere over the waves" like it was yesterday. She always finished the story by telling how Anna Liza then laid the violin aside and drew her last breath.
My father could always pick up just about any instrument and play a tune on it. He continues to be one of our song directors at age 79 at our church. He always told me, "Whatever you do, always go back to your music because music can heal you." Thank you, my dad, the philosopher.
With yet another study demonstrating such a dramatic benefit with music therapy, I'm bound to pass that one along to my recovering ACS patients. In south central Kentucky, will it be Beethoven or Brooks and Dunn? As long as it's not AC/DC, I guess it really doesn't matter. What matters is that we discuss this small but important study with our patients as yet another safe and inexpensive opportunity to improve outcomes.