Heart Attack And Mental Health

What is a heart attack?

A heart attack is also called a myocardial infarction or MI and is a serious medical emergency. Most heart attacks are due to underlying coronary artery disease, which is a leading cause of death. To survive, the heart muscle needs oxygen. A heart attack happens when the blood flow that supplies oxygen to the heart muscle is significantly lowered or entirely stopped.1 Ischemia results when the heart muscle is starved for oxygen and nutrients.1 Myocardial infarction, sometimes known as a heart attack, is the medical term for when ischemia causes damage to or death of a portion of the heart muscle (MI). In individuals 20 and older, the prevalence of myocardial infarction is 3.1%.2 According to the American Heart Association, it usually takes about eight weeks for the heart muscle to heal after a heart attack. A heart attack might result in lasting cardiac damage and perhaps death if blood flow isn't promptly restored.

Symptoms of a heart attack

The main heart attack symptoms include:

  • Chest pain that appears suddenly and does not go away. The pain can feel like squeezing, pressure or tightness
  • Nausea or vomiting
  • Pain in other body regions than the chest - You may experience pain that seems to be spreading from your chest to your arms (it is possible for both arms to be affected but mainly the left arm), jaw, back, neck, and stomach.
  • Sweating
  • Shortness of breath
  • Feeling light-headed

There are also less common symptoms, including:

  • Excessive coughing or wheezing caused by a buildup of fluid in the lungs
  • A sudden feeling of fear or anxiety that can feel like a panic attack

Panic attack vs heart attack

Although both a panic attack and a heart attack can cause chest pain, the pain's symptoms vary. Stress hormones cause the body's "fight or flight" reaction, which frequently emerges as a racing heart, chest pain, and shortness of breath. This is how panic attacks start.3

  • A panic attack can happen at rest, but a heart attack frequently happens while you're active.
  • Both panic attacks and heart attacks cause shortness of breath and sweating
  • Panic attacks occur under stress and extreme anxiety
  • A panic attack resolves by itself and takes around 15-20 minutes to get better. However, a heart attack will be continuous and can worsen over a period of time.

There are numerous therapy options available if it is established that the symptoms are related to a panic attack.

Effects of a heart attack on mental health

Health anxiety (hypochondria)

Although heart attacks occur during active periods, it is important that avoidance behavior does not occur. Individuals should still exercise as this could improve their health. A heart attack can lead to what is known as cardiac anxiety, which can have a negative impact on a patient's daily life.

Depression

It's not uncommon to develop depression after having a heart attack. This can also happen and vice versa. Research has shown that there is a higher risk of heart attack in individuals who suffer from depression.3 Heart disease medication along with other lifestyle adjustments has been said to reduce depression symptoms.

Anger

Anger is common when you have a health condition like a heart attack. There can be several reasons why you feel angry after a heart attack. You might feel like you did not deserve the heart attack and other people deserve it more. You might feel angry because of how you were treated by doctors, for instance, if it has taken the doctors a while to understand your health issues, and your appointments are sometimes cancelled. In some patients, their lifestyle changes as they cannot do certain activities anymore and they might feel anger because of that.6

Worry about loved ones

After experiencing a stressful experience like a heart attack, it is normal to worry about your loved ones as you do not want them to go through the same experience as you.

When should you contact a doctor?

You should see a doctor if you:

  • Have symptoms of depression and anxiety that are not improving.
  • Find your mood affects your work, relationships with your family and friends, and everyday life.
  • Have thoughts of suicide or self-harm.

If you think you are having a heart attack, you should call 999 immediately.

If you are concerned about your or your loved one’s mental health

Mind - 0300 123 3393 (Infoline) - Mind is a charity that offers support and advice to those with mental health problems

Anxiety UK  - 03444 775 774 (helpline) or 07537 416 905 (text) - This charity provides support and advice to anyone who is suffering with anxiety

NHS Improving Access to Psychological Therapies (IAPT) - nhs.uk/service-search/find-a-psychological-therapies-service - The NHS provides counselling and therapy services. You are able to self-refer to these services if needed. Please note that this service is only available in England.

Samaritans -116 123 (freephone) - A charity that provides emotional support for those who are struggling to cope, having suicidal thoughts, or are feeling distressed.

Conclusion

A heart attack is a critical medical emergency that occurs when the blood supply to the heart is suddenly cut off, typically by a blood clot. A heart attack is an urgent medical situation. If you think you could be or someone else is having a heart attack, dial 999 and ask for an ambulance. A shortage of blood to the heart can be fatal and significantly harm the heart muscle. Along with having a physical impact, heart diseases also have psychological and emotional effects. However, there are many healthy changes you can make to improve mental wellbeing and prevent a heart attack.

References

  1. Ojha N, Dhamoon AS. Myocardial Infarction [Internet]. Nih.gov. StatPearls Publishing; 2022 [cited 2022 Sep 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537076/
  2. ‌2. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart Disease and Stroke Statistics—2011 Update. Circulation [Internet]. 2011 Feb [cited 2022 Sep 21];123(4). Available from: https://pubmed.ncbi.nlm.nih.gov/21160056/
  3. Cackovic C, Nazir S, Marwaha R. Panic Disorder [Internet]. Nih.gov. StatPearls Publishing; 2022 [cited 2022 Sep 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430973/
  4. Heart disease and depression: A two-way relationship [Internet]. NHLBI, NIH. 2017 [cited 2022 Sep 22]. Available from: https://www.nhlbi.nih.gov/news/2017/heart-disease-and-depression-two-way-relationship
  5. Cherney K. Depression After a Heart Attack: Steps to Get Better [Internet]. Healthline. Healthline Media; 2019 [cited 2022 Sep 22]. Available from: https://www.healthline.com/health/heart-health/depression-after-heart-attack
  6. British Heart Foundation. Dealing with anger [Internet]. Bhf.org.uk. British Heart Foundation; 2020 [cited 2022 Sep 22]. Available from: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/wellbeing/mental-health/dealing-with-anger

Dechante Johnson

BSc Neuroscience, University of Exeter, England

Dechante is a 3rd year neuroscience student at the University of Exeter. She has recently carried out research at the University of Western Ontario, Canada where she investigated the "Sensory filtering in Autisic Models". Dechante's main interests are clinical neuroscience, behavioural sciences, health policy and understanding the inequities in healthcare. She is particularly interested in using interdisciplinary biomedical research to answer complex questions and global problems in medicine and health. Dechante is passionate about medical communications and believes that patients should be fully aware of the options available to them and give the public complex information about health into simplistic terms.

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