Samuel $Barber always preferred the title Medea for the ballet he and Martha Graham premiered in 1946 as The Serpent Heart, Op. 23. When the work was revised and retitled Cave of the Heart in 1947, Barber decided to expand certain portions into an orchestral suite with the same title.

The ballet and seven-movement suite, based loosely on the mythological tale of Medea, are intended to represent the timeless psychological states of jealousy and rage rather than literally reflect the myth itself. The suite follows the basic form of a Greek tragedy: parodos, choros, action, choros, action, choros/interlude, and exodos.

Barber's music juxtaposes the ancient and the modern, combining angry, primal rhythms with the composer's trademark Romantic melodies. The opening movement, parodos, sets the stage and introduces the characters. The main body of action then takes place, interspersed throughout with commentary from the choros, which eventually brings the drama to a close. The exodos, as in Greek drama, briefly revisits the main themes a final time before the themes blend with each other and gradually fade back into the mists of myth.

Cave of the Heart was premiered by the Philadelphia Orchestra under Eugene Ormandy on 5 December 1947.

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