by Carolyn Thomas ♥ @HeartSisters
I’ve sometimes heard doctors describe a heart attack as “small”. But only doctors – you’ll rarely hear a heart attack survivor say it. Doctors who talk this way are looking only at blood tests that assess heart muscle damage, angiograms for coronary artery blockages, EKG readings for erratic heartbeats, and echocardiograms for valve damage or reduced heart function.
If these test results on paper aren’t too deadly – well, it must be only a “small” heart attack.
But a study reported in the Canadian Journal of Cardiology last month reinforced what all heart attack survivors already know but their doctors may not: a heart attack can leave people as psychologically traumatized as victims of violence.
Montreal researchers led by Dr. Gilles Dupuis of the Université du Québec and the Montreal Heart Institute say that post-traumatic stress disorder (PTSD) following a heart attack is an under-diagnosed and unrecognized phenomenon that can actually put survivors at risk of another attack.
The researchers found that, one month out, a significant number of heart-attack victims show symptoms of PTSD, such as frequent nightmares or flashbacks, or a constant reliving of the fear, helplessness or horror felt when they were having the heart attack and thought they were dying.
Dr. Dupuis explained:
“It’s as if you are in a bank and there’s a holdup – you have all those flashbacks that come back into your mind. You can have trouble sleeping, and become depressed or anxious.”
In fact, some of his almost 500 study patients had to be interviewed by telephone because they were so afraid of returning to the hospital and reliving the memory of the heart attack.
The psychological fallout can have a profound impact on a patient’s recovery, said Dr. Peter Liu, a professor of medicine of the University of Toronto and Toronto General Hospital. He explained:
“Depression alone increases the risk of dying after a heart attack by 20-25%. The stress response can cause not just psychological trauma, but also physiological changes – such as increased heart rate and blood pressure – that further harm an injured heart.”
This stress response syndrome that occurs so frequently after a serious health crisis like a heart attack is also known as “situational depression”. It’s what mental health professionals call an adjustment disorder that can strike within weeks following a traumatic life event as we struggle to make sense of something that makes no sense. The good news is that, unlike clinical depression, it typically tends to run its course over about a six-month period, often eventually fading even without treatment.
Find out more about the PTSD study from the Canadian Journal of Cardiology .
- 10 Non-Drug Ways to Treat Depression in Heart Patients
- Post-Traumatic Stress Disorder: Not Just For Soldiers Anymore
- The New Country Called Heart Disease
- Handling the ‘Homecoming Blues’: the Third Stage of Heart Attack Recovery’
- Living With the “Burden of Treatment”
- “We Are All Patients.” No, you’re not.
- “Welcome to Holland!”
- Are You Too Hard On Yourself?
- Depressing News about Depression and Heart Disease
- Not Just For Soldiers Anymore: Post Traumatic Stress Disorder After A Heart Attack
- Women Heart Attack Survivors May Be as Psychological Traumatized as Victims of Violence
- Top 10 Tips From the Author of ‘How to be Sick’
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Heart Sisters 
Following my heart attack two and 1/2 years ago, I’ve been admitted to hospital 8 times. With each admission, I went through at least one invasive procedure, and eventual bypass surgery, and multiple side effects and things gone wrong.
I found myself crying uncontrollably just at the thought that I might have to, for example, go back for another adenosine stress test, or another angiogram. Only recently, after another hospitalization, did I begin to realize that I have PTSD, directly related to the medical trauma I experienced over and over. While no one wished me harm, no staff person, MD or nurse seemed to get it that I was in big trouble, emotionally. In fact, now my angina is ALWAYS triggered by anxiety, which is most often related to my medical experiences.
It’s starting to be a very long journey to recovery.
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I think that title may be an understatement. It’s also the family of heart attack survivors who suffer as well.
I’m an RN and by no means unfamiliar with heart disease, etc. However my mother in law died at age 42 from a heart attack that was diagnosed as angina (she was sent home with nitro and died before she got there), and my husband had a heart attack at 37 (he’s 39 now). It has been so traumatizing for our entire family.
Still every pain, symptom, complaint from him puts me in panic mode. He basically died the moment I arrived at the hospital with him in the car – he was fully coded and he also remembers most of that entire event. He suffers, but we, especially me, are right there with him still suffering.
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I agree, Ann. This is true in all medicine, in my opinion. Family members are rarely on the radar screen. When I worked in hospice palliative care, our in-patient program was unusual because we focused equally on both patient AND family members facing end-of-life care issues.
I wrote about the spouse’s experience last year in “When Your Hubby is the Heart Patient” at: https://myheartsisters.org/2009/12/04/hubby-heart-pnt/
cheers,
C.
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I think having a severe heart attack is generally worse than being a victim of violence — in violence, one can see the source of harm as outside the self and the body, and can get some (at least slight) distance on it.
With a heart attack, it is one’s own body which is the source of violence/betrayal, and the loss of the trust in the body can be profound…
… Excellent article: the trauma of a heart attack is vastly under-rated by cardiologists and other physicians…
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I read your posts all the time and find them interesting and helpful. This one jumped out and grabbed me.
I was a hostage in a bank robbery in 1984. A gun was pressed to my head for two minutes and I was waltzed around the bank lobby with the robber threatening to kill me.
As much as I like to believe I got past this, I must say that I retired from banking in 2000 and my near fatal heart attack occurred in 2003. It was the first in my family, and I often wondered “why me”.
A lot of things in my life changed after that robbery including the beginning of nightmares. I feel guilty thinking I might suffer PTSD when my spouse, a Vietnam veteran with six tours in Southeast Asia, manages his life so well. However, he has heart disease too.
Perhaps I will share this information with my cardiologist, but I can’t imagine what can be done now.
Thank you for all your great information.
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It’s about time someone has recognized this! I am living proof that it exists and other women need to know this does not mean they are crazy; just normal!
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Finally, it feels like someone is beginning to understand the emotional elements of women heart attack survivors!
Thank you-Thank you-Thank you!
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For a while after the heart attack and emergency heart surgery, I would burst into tears when a doctor wanted to do anything to me, like take out my stitches. I mean bawl-baby crying. I panicked when my daughter had to go back home, I cried like a heart-broken little child. I was ashamed and embarrassed then, but I look back on it after reading this article and realize I probably was suffering like any PTSD patient.
Thank God, I’m a positive kind of person and got over it, but it was hell and nobody told me it was normal.
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Thank you so much for this article. This is me inside and out. I have always been afraid to tell anyone this is how I feel. I’m afraid they will think I’m nuts. I’m sending this to both my cardiologist and primary care physician.
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