Many recovering heart attack patients speak of their experience as a wake-up call or a second chance. They are inspired to stop smoking, lose weight, start exercising or make other changes that will help prevent another heart attack.
For some patients, however, a heart attack can bring on feelings of sadness and even can trigger depression that can impact recovery.
The causes of depression in MI (myocardial infarction, or heart attack) patients are unknown, but data shows that depression can lead to poorer outcomes by making patients less compliant with their treatment plan. They may not take prescribed medications, make negative lifestyle changes or fail to participate in cardiac rehabilitation.
The link between depression and poor outcomes led the American College of Cardiology and the American Heart Association to recommend evaluation for symptoms of depression for coronary artery by-pass graft (CABG) surgery, acute MI and chronic angina patients. Doctors use a variety of tools and screening surveys to identify symptoms of depression.
A key indicator for me is if a patient doesn't say he or she feels lucky or is ready to make some positive lifestyle changes after a heart attack or heart surgery. Often it's family members who pick up on these signs.
Here are some ideas for helping your loved one following a heart attack or heart surgery:
When appropriate, encourage the patient to get up and get dressed every day, walk, get a good night's sleep and eat well-balanced, nutritious meals;
Encourage the patient to take prescriptions, attend rehabilitation therapy sessions and follow any recommended lifestyle changes;
Help the patient get back to hobbies and social activities he or she enjoys;
Look for support groups for the heart patient and for you;
Be consistently supportive, take breaks from caregiving and understand that hostility, rejection and irritability may be signs of depression;
Watch for signs of harmful coping habits such as smoking, drug use, drinking or overeating excessively;
Learn the signs of depression and don't wait to encourage the heart patient to talk to the doctor about his or her symptoms.
Temporary feelings of sadness following heart surgery or heart attack are fairly common. It also is normal for the patient to have concerns about getting into old routines and activities.
When the condition prevents the patient from complying with treatment, affects relationships or performance at work or home, however, the patient's family doctor or cardiologist should be informed.
While treatment for depression in cardiac patients doesn't necessarily improve outcomes, it does improve compliance with treatment and makes the patient feel better. It's an important consideration for heart patients because of the impact on their quality of life.
Nardone is an interventional cardiologist at Susquehanna Health's Heart & Vascular Institute. He is board certified in cardiovascular disease and interventional cardiology and has provided cardiology services in the region for 19 years.
