1 Department of Psychology, Faculty of Social Sciences, Aarhus University, Aarhus University2 Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University3 Tilburg University4 Department of Psychology and Behavioural Sciences, Aarhus BSS, Aarhus University
Background There is increasing recognition that patients following a cardiac event may be at riskof developing PTSD. The present article reviews studies looking at PTSD as a sequel of heart disease witha particular focus on prevalence and risk factors. Potential pathogenic pathways that may link PTSD toadverse prognosis are also discussed.Methods We conducted a search on PsychInfo and Medline from 1980 to the present using a pre-definedset of search terms. In total, we identified 26 studies that fulfilled our inclusion criteria.Results The prevalence of PTSD following heart disease varied from 0-38% across studies. Studies thatincluded control groups showed that cardiac patients were at a significantly increased risk of developingPTSD. Risk factors included gender, personality, and low social support. Possible mechanisms comprisedelevations in heart rate and blood pressure, and lack of adherence with lifestyle changes and medication.Conclusions Subgroups of patients with established heart disease are at risk of developing PTSD following acardiac event. Although few studies have looked at the impact of PTSD on prognosis, preliminary evidencesuggests that PTSD may increase the risk of major adverse cardiac events. Therefore there is an urgentneed for sufficiently powered prospective studies that look at the clinical course of PTSD and its impact onprognosis. This would lead to further knowledge of risk factors for the development of PTSD in cardiacpatients, a better understanding of the pathogenic pathways, and more optimal risk stratification in researchand in clinical practice.