Ludwig van Beethoven is inarguably one of the greatest and well-known musical figures in the world. He was a deaf German composer who helped transition music from the Classical to Romantic era, and his heartbeat may be the reason for such a predominant musical movement, according to a cardiologist, medical historian, and musicologist who published their findings in the journal Perspectives in Biology and Medicine.

“His music may have been both figuratively and physically heartfelt,” the study’s coauthor Joel Howell of the University of Michigan Medical School, said in a press release. “When your heart beats irregularly from heart disease, it does so in some predictable patterns. We think we hear some of those same patterns in his music.”

Some of Beethoven’s most famous works were analyzed by a team of researchers from the University of Michigan Medical School in collaboration with University of Washington. They found the rhythms in certain parts of his renowned works could have been written based off his irregular heartbeats. Beethoven had cardiac arrhythmia, which causes the heart to beat too fast, too slow, or with an irregular rhythm.

“The synergy between our minds and our bodies shapes how we experience the world,” Howell said. “This is especially apparent in the world of arts and music, which reflects so much of people's innermost experiences.”

Beethoven's Heartfelt Music

The researchers studied the ebb and flow of his rhythm and found it could trail along the same pattern as an irregular heartbeat would cause. Beethoven’s final movement in “Cavatina” features a String Quartet in B-flat Major, which suddenly becomes dark and sad in the middle of the piece. The rhythm takes listeners to an off rhythm that could mirror an irregular heartbeat caused by cardiac arrhythmia. Beethoven said the section should be played “beklemmt,” which translates to “heavy hearted” or “anguished” in German. The emotionally enchanting piece made Beethoven weep as he played, as it moves in C-flat major and transforms into an unbalanced rhythm of disorientation.

“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,” the study’s lead author Dr. Zachary D. Goldberger, a cardiologist at Harborview Medical Center, University of Washington School of Medicine, said in a press release. “However, the symptoms and common association of an abnormal heartbeat with so many diseases makes it a reasonable assumption that Beethoven experienced arrhythmia — and the works we describe may be 'musical electrocardiograms,' the readout of modern heart rhythm testing equipment.”

Beethoven was plagued with a series of mysterious health conditions, aside from his heart, including inflammatory bowel disease, abnormal bone destruction, liver disease, alcohol abuse, and kidney disease. His most commonly known ailment was his deafness, which could have heightened his other senses. Researchers believe this could have made him even more aware of the irregularity of his heartbeat, so much so it was one of the greatest influences on his music.

“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,” Goldberger said.

Source: Goldberger ZD, Whiting SM, and Howell JD. The Heartfelt Music of Ludwig van Beethoven. Perspectives in Biology and Medicine. 2015.