When sweat started pouring off of him during his morning routine, he realized, "I'm having a heart attack" -- and proceeded to collapse.
Paramedics rushed him to the hospital, where doctors diagnosed and treated him for a major heart attack. Dorman survived this initial episode, as well as three subsequent surgeries to place stents and implant a defibrillator into his chest.
Physically, Dorman recovered from his heart attack and the operations. Mentally and emotionally, it was a different story.
"I went through a period of depression," said Dorman, now 64. "I was becoming non-functional. I didn't enjoy anything in the world.
"Sleeping is a big problem," he added. "You stub your toe and think it's a heart attack. My blood pressure is high on a good day."
Today, Dorman lives with Post-Traumatic Stress Disorder, or PTSD for short. PTSD is a type of anxiety that occurs after a severely frightening experience. Sufferers experience nightmares, high blood pressure and an increased heart rate. Often, they live in fear of things that would remind them of the initial traumatic event. PTSD is usually associated with war, assault, abuse and violence -- but new research suggests that heart patients also battle this disorder. Donald Edmondson, a professor of behavioral medicine specializing in cardiovascular health at Columbia University Medical Center in New York, led a study examining the relationship between heart attack and PTSD. This review of 24 studies involved more than 2,000 patients, and revealed that one in eight heart patients develop significant symptoms of PTSD.
Considering the fact that 1.4 million Americans are hospitalized for cardiac events each year, the findings suggest a substantial portion of the population may be living with psychological trauma and not realize why.
"I became interested in the relationship between PTSD and heart attacks after watching my patients," Edmondson said. "Once the physical threat is over, the family is ready to move on. But for the patients themselves, it's not over with. It's with them every day. "
Dorman, who had to stop his work in the printing industry because of his heart condition, said that before suffering his heart attack at age 52, he enjoyed being a competitive squash player, scuba diver and gardener.
"That all changed after the doctor told me I wasn't ever going to work again," Dorman said.
"Slowly but surely, this thing has robbed me of everything I loved," he said. "My marriage broke up. I can't do my old hobbies. Some days, I feel like a cardiac cripple."
Worse, the new analysis also suggests that heart patients who suffer PTSD face twice the risk of having another cardiac event -- or even dying within one to three years -- compared to patients without psychological symptoms.
"Heart attacks can be dramatic events," said Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University in Durham, N.C. "It's not unlike what it is like for a soldier when a bombs goes off. You know something is terribly wrong, you might die and you cannot control it.
"It's no surprise that heart attack patients develop PTSD, and that it increases their chance of having yet another attack," Williams said.
Fortunately, things improved for Dorman. Although initially reluctant to see yet another doctor or take another pill, he was eventually prescribed an antidepressant -- a medication that he said improved his life immensely. Psychological therapy is another safe and effective option for some heart attack patients.
Doctors hope that knowing about the specific relationship between heart attack and PTSD will continue to improve treatment for better mental and physical health.
"We can't intervene on the battlefield to prevent soldiers from getting PTSD," Edmonson said. "But there may be things we can do to help protect our patients." The toll of a heart attack may be more than just physical. Patients who suffer heart attacks could also suffer from post-traumatic stress disorder -- which could raise the risk of another heart attack, according to a study in the journal PLoS ONE.
Post-traumatic stress disorder, or PTSD, is an anxiety disorder that often develops after a traumatic event involving the threat of injury or death, according to the National Institutes of Health. It can cause debilitating flashbacks, trouble in relationships and difficulties with sleep.
It's perhaps best known as one of the hallmarks of soldiers returning home from war, but it can occur after many different types of events, including domestic violence, terrorism, even natural disasters like earthquakes and floods. By definition, a heart attack falls within this category.
To test this relationship, the researchers looked at the results from 24 studies involving nearly 2,400 heart patients, and found that about 12% of heart attack patients went on to develop PTSD symptoms. And 4% of heart patients met the full criteria for the disorder.
The researchers also found that those heart attack patients with PTSD symptoms were twice as likely to have a second heart attack or die as the heart attack patients without PTSD symptoms.
So if there were some treatment to reduce the heart-attack-linked PTSD, perhaps this could help reduce the risk of a second heart attack -- though further research is needed on this point, the authors wrote.
Other work has shown it's possible to reduce PTSD by dealing with the problem very soon after the trauma. A 2010 study in the New England Journal of Medicine looked at U.S. soldiers wounded during Operation Iraqi Freedom, and found that giving them morphine within a few hours of their injury essentially dulled the memory of the trauma -- and actually reduced their risk of developing PTSD by 50%.
1 comments:
This is very informative post regarding for those who live after heart attack. Thanks for sharing such a great article.
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