The Intersection of Mental Health, Cardiac Crises, and CPR Education

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The Intersection of Mental Health, Cardiac
Crises, and CPR Education
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Recovering from a heart attack, cardiac arrest,
or major heart surgery involves not only physical
healing but also mental and emotional well-being,
which can often be overlooked. Experts emphasize
that issues like depression, anxiety, and
post-traumatic stress not only affect patients
but also have a direct impact on their
recovery. Julie Cunningham, a clinical health
psychologist at Samaritan Medical Group in
Corvallis, Oregon, who works with cardiac
patients, stresses the importance of addressing
depression for both mental health and cardiac
well-being. Patients with depression tend to have
slower recovery rates after heart surgery, making
it challenging for them to engage in crucial
rehabilitation programs like cardiac rehab.
Additionally, a depression diagnosis following a
heart attack has been linked to a higher risk of
death, according to a study published in the
European Heart Journal Quality of Care and
Clinical Outcomes in 2017.
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Mental health disorders can manifest after
various cardiac conditions. Studies have shown
that depression or anxiety affects over 30 of
individuals who undergo aortic heart valve
replacement and 30 to 40 of those who undergo
heart bypass surgery. Different cardiac
experiences pose unique mental health risks. Dr.
Sachin Agarwal, director of the NeuroCardiac
Comprehensive Care Clinic at Columbia University
in New York, explains that survivors of heart
attacks, where blood flow to the heart is
blocked, may experience symptoms such as chest
pain or shortness of breath and may develop
post-traumatic stress disorder (PTSD). Around 1
in 8 heart attack survivors experience
post-traumatic stress. People who have suffered
even minor strokes often describe feelings of
terror, and nearly 1 in 4 stroke survivors
experience PTSD a year later, as per a study
published in the American Psychologist in 2018.
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Those who have undergone cardiac arrest, where
the heart suddenly stops, may wake up days or
weeks later in an intensive care unit (ICU) with
no recollection of what transpired. About a third
of cardiac arrest survivors experience PTSD
symptoms and as many as half exhibit signs of
depression at the time of hospital
discharge. Psychological distress in cardiac
arrest survivors has been extensively studied,
revealing that individuals experiencing PTSD
symptoms often exhibit anxiety, hypervigilance,
difficulty concentrating or sleeping, and
avoidance of places or behaviors that remind them
of the traumatic event. Agarwal further notes
that heart surgery can lead to cognitive problems
in addition to mental health issues. Prolonged
hospitalization can contribute to conditions
known as post-hospital syndrome or post-ICU
syndrome, which encompass a range of physical and
psychological challenges.
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Numerous biological connections between
depression and heart disease have been
identified, and a cardiac crisis can trigger a
host of emotional issues. Patients may fear a
recurrence of sudden health problems or feel
despondent due to worsening long-term conditions.
Their physical abilities may be diminished,
preventing them from working or participating in
hobbies and exercise as they used to. Roles can
also reverse, with caregivers suddenly becoming
the ones in need of care. This shift can pose
risks for caregivers themselves. Cunningham
highlights that a cardiac crisis can
significantly impact the family unit. In her
experience, she observes that patients come to
visit with loved ones more often than any other
patient population. Loved ones may feel stress as
they desire to help with the recovery process but
are unable to control the situation. Adult
children may also be taken aback when they
discover they could inherit a condition that
jeopardizes their own health.
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Agarwal points out that family members of cardiac
arrest survivors may experience a distinct form
of trauma. Since most out-of-hospital cardiac
arrests occur at home, family members often find
themselves in a position of calling emergency
services, administering CPR, making difficult
decisions, and wondering if their loved one will
recover. While survivors of cardiac crises face
existential concerns as they come to terms with
what happened and worry about the future,
witnesses - often close family members - carry
memories of the entire ordeal and grapple with
classic symptoms of PTSD, such as flashbacks. In
fact, studies have shown that family members of
cardiac arrest survivors may experience even
higher levels of distress than the survivors
themselves, as reported in a review published in
the journal Resuscitation Plus in March.
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The emotional challenges faced by loved ones can
also have an impact on the health of the heart
patient if it hinders the caregivers' ability to
provide the necessary care. Recognizing the
far-reaching effects of mental health on cardiac
recovery, Dr. Agarwal and other researchers are
actively exploring ways to predict mental health
issues in cardiac patients and incorporate
families into the healing process. Dr. Agarwal
emphasizes the need for healthcare systems to
proactively provide resources to families and
patients rather than leaving them to seek help on
their own. The responsibility lies with medical
professionals to ensure that equitable access to
resources is available to those who need them the
most.
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Cunningham shares similar sentiments, emphasizing
the importance of having conversations with
patients to help them connect the dots and
recognize the presence of depression and anxiety.
Patients and their families need to understand
that these mental health challenges are common
and do not reflect any personal shortcomings.
Acknowledging and addressing these issues is a
crucial step toward holistic recovery. The
mental well-being of individuals recovering from
cardiac crises is as important as their physical
health. Depression, anxiety, and post-traumatic
stress can significantly impact recovery rates
and overall cardiac health. Healthcare providers
need to prioritize mental health support, offer
specialized programs like cardiac rehabilitation,
actively involve families in the healing process,
and also recognize the psychological impact of
CPR during cardiac emergencies.
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Additionally, promoting widespread CPR training
and education within communities can empower
individuals to respond effectively during cardiac
emergencies, not only saving lives but also
providing the necessary support for individuals
to navigate the emotional challenges that can
arise from such critical situations. By
addressing both the physical and emotional
aspects of recovery, along with comprehensive CPR
training and education, we can enhance the
well-being and quality of life of those affected
by cardiac crises.
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Source https//www.heart.org/en/news/2023/05/23/w
hy-a-cardiac-crisis-also-can-be-a-mental-health-is
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