Researchers say they can hear patterns of irregular heartbeat in Beethoven's music.
This surprising suggestion comes from a team that includes a medical historian, a cardiologist and a musicologist from the University of Michigan (U-M) at Ann Arbor and the University of Washington (UW) School of Medicine in Seattle.
They describe how they arrived at the idea in a paper published in the journal Perspectives in Biology and Medicine.
Beethoven lived and composed his great masterpieces 200 years ago, and there is little reliable evidence of his health and afflictions. His most often described ailment was his deafness, which the authors suggest could have heightened his awareness of his heartbeat, causing the great man to make music by literally following his heart.
There are also theories that Beethoven suffered from many other health problems, including liver disease, alcohol abuse, kidney disease, inflammatory bowel disease and abnormal bone destruction, or Paget's disease.
First author Zachary D. Goldberger, assistant professor of medicine in the Division of Cardiology at UW School of Medicine, says:
"We can't prove or disprove that Beethoven had many of the diseases he's been supposedly afflicted with because almost all of today's diagnostic medical tests didn't exist in the 18th century, and we are interpreting centuries-old medical descriptions into the context of what we know now."
'Musical electrocardiograms' reveal arrhythmia patterns in Beethoven's pieces
Arrhythmia is a condition where there is a change from the normal sequence of electrical impulses in the heart. As a result, the heart may beat irregularly (fibrillation), too fast (tachycardia), too slowly (bradycardia) or too early (premature contraction).
For the study, the team examined the rhythm of several of Beethoven's compositions and found patterns that Prof. Goldberger says match what they describe as "musical electrocardiograms," like the readout of modern heart rhythm testing equipment.
Sudden, unexpected changes in pace and keys appear to match the asymmetrical patterns of irregular heartbeat - too fast, too slow or irregular, say the researchers.
For example, one of the pieces they studied is the "Cavatina" final movement of Beethoven's String Quartet in B-flat Major, Opus 130. Beethoven said this passage made him weep.
In the middle of the Cavatina, the key changes abruptly to C-flat major. Together with the unbalanced rhythm, this sudden change evokes a dark emotion and disorientation that some have described as akin to "shortness of breath."
"The arrhythmic quality of this section is unquestionable," note the authors.
Did 'heavy of heart' mean Beethoven felt pressure on his heart?
In his directions for playing the piece, Beethoven uses the German word "beklemmt" to indicate "heavy of heart." The authors suggest that while "heavy of heart" could be taken to mean sadness, in a more literal sense it could mean a feeling of pressure, which is associated with heart disease.
The team also spotted arrhythmic patterns in some of Beethoven's other pieces. They found them in the Piano Sonata in A-flat major, Opus 110, and the opening of the "Les Adieux" Sonata opus 81a in E-flat major, which Beethoven wrote during Napoleon's attack on Vienna in 1809.
Prof. Goldberger comments:
"While these musical arrhythmias may simply manifest Beethoven's genius, there is a possibility that in certain pieces his beating heart could literally be at the heart of some of the greatest masterpieces of all time."
In August 2014, Medical News Today reported how increasing the amount or intensity of exercise can decrease risks of developing arrhythmia. This was the conclusion of a Stanford-led study of older women that found, compared with the least active, the most physically active women had a 10% lower risk of developing atrial fibrillation - a heart condition that causes arrhythmia. And this was true even if the women were obese.