Emotional stress and sympathetic activity: Contribution of dorsomedial hypothalamus to cardiac arrhythmias

•Emotional stress leads to cardiovascular disease.•Increase in sympathetic activity is a hallmark of the response to emotional stress.•Dorsomedial hypothalamus is a key region for the sympathetic response to stress.•Dorsomedial hypothalamus can be involved in generation of cardiac arrhythmias.

Maintenance of homeostasis in normal or stressful situations depends upon mechanisms controlling autonomic activity. Central requirement for changes in sympathetic output resulting from emotional stress must be adjusted to the input signals from visceral sensory afferent (feedback response) for an optimum cardiovascular performance. There is a large body of evidence indicating that emotional stress can lead to cardiovascular disease. Reviewing the descending pathways from dorsomedial hypothalamus, a key region involved in the cardiovascular response to emotional stress, we discuss the interactions between mechanisms controlling the sympathetic output to the cardiovascular system and the possible implications in cardiovascular disease.