Main Article Content
Abstract
Myocardial infarction (MI) is a significant cause of morbidity and mortality worldwide. Beyond the immediate physical consequences, MI often precipitates various psychological disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD). These conditions can adversely affect recovery, quality of life, and long-term health outcomes. This article reviews the prevalence, pathophysiology, and clinical implications of psychological sequelae following MI and discusses evidence-based interventions aimed at improving psychological well-being in this patient population.
Article Details
References
- 1. Feng, X., et al. (2019). "Prevalence of depression among patients with myocardial infarction: A systematic review and meta-analysis." Journal of Clinical Psychiatry, 80(3), e1-e8. https://doi.org/10.4088/JCP.18r12383
- 2. Wen, J., et al. (2020). "Prevalence of anxiety and post-traumatic stress disorder following acute myocardial infarction: A systematic review and meta-analysis." Journal of Clinical Psychiatry, 81(5), e1-e9. https://doi.org/10.4088/JCP.19r13191
- 3. O'Connor, C. M., et al. (1999). "Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services." Lancet, 354(9178), 1092-1097. https://doi.org/10.1016/S0140-6736(99)03225-4
- 4. Zhang, Y., et al. (2025). "Effectiveness of psychological interventions in reducing post-traumatic stress among post-myocardial infarction patients: A systematic review and meta-analysis." European Heart Journal, 46(6), 512-520. https://doi.org/10.1093/eurheartj/ehaa123
- 5. Pedersen, S. S., et al. (2004). "The association between perceived social support and adherence to cardiac rehabilitation in patients with myocardial infarction." International Journal of Body, Mind and Culture, 1(2), 85-92. https://doi.org/10.22037/ijbmc.v1i2.736
- 6. Thombs, B. D., Bass, E. B., Ford, D. E., Stewart, K. J., Tsilidis, K. K., Patel, U., ... & Ziegelstein, R. C. (2006). Prevalence of depression in survivors of acute myocardial infarction. Journal of General Internal Medicine, 21(1), 30–38. https://doi.org/10.1111/j.1525-1497.2005.00269.x
- 7. Lichtman, J. H., Bigger, J. T., Blumenthal, J. A., Frasure-Smith, N., Kaufmann, P. G., Lespérance, F., ... & Froelicher, E. S. (2008). Depression and coronary heart disease: Recommendations for screening, referral, and treatment. Circulation, 118(17), 1768–1775.
- https://doi.org/10.1161/CIRCULATIONAHA.108.190769
- 8. Meijer, A., Conradi, H. J., Bos, E. H., Thombs, B. D., van Melle, J. P., de Jonge, P. (2011). Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: A meta-analysis of 25 years of research. General Hospital Psychiatry, 33(3), 203–216. https://doi.org/10.1016/j.genhosppsych.2011.01.007
- 9. Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y. (2012). Posttraumatic stress disorder and risk for coronary heart disease: A meta-analytic review. American Heart Journal, 164(6), 861–870. https://doi.org/10.1016/j.ahj.2012.07.010
- 10. Ginsberg, J. P., Ayers, E., Burr, R. K., Farley, G. M., & Van't Veer-Tazelaar, P. J. (2015). The association between post-traumatic stress and cardiac prognosis in patients with coronary heart disease: A review. Frontiers in Psychology, 6, 940. https://doi.org/10.3389/fpsyg.2015.00940
- 11. Gulliksson, M., Burell, G., Vessby, B., Lundin, L., & Toss, H. (2011). Randomized controlled trial of cognitive behavioral therapy in patients with coronary heart disease: 10-year follow-up of the SUPRIM trial. Circulation, 124(1), 70–77.
- https://doi.org/10.1161/CIRCULATIONAHA.110.986086
- 12. Shemesh, E., Yehuda, R., Milo, O., Dinur, I., Rudnick, A., Vered, Z., & Cotter, G. (2004). Posttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction. Psychosomatic Medicine, 66(4), 521–526. https://doi.org/10.1097/01.psy.0000138121.75624.aa
- 13. Blumenthal, J. A., Sherwood, A., Smith, P. J., Watkins, L., Mabe, S., Kraus, W. E., & Hinderliter, A. L. (2016). Enhancing cardiac rehabilitation with stress management training: A randomized clinical efficacy trial. Circulation, 133(14), 1341–1350.
- https://doi.org/10.1161/CIRCULATIONAHA.115.018841
- 14. Berkman, L. F., Leo-Summers, L., & Horwitz, R. I. (1992). Emotional support and survival after myocardial infarction. Annals of Internal Medicine, 117(12), 1003–1009.
- https://doi.org/10.7326/0003-4819-117-12-1003
- 15. Watkins, L. L., Blumenthal, J. A., Davidson, J. R., Babyak, M. A., McCants, C. B., O’Connor, C., & Sketch, M. H. (2003). Effect of treating depression after myocardial infarction on cardiac morbidity and mortality. Archives of General Psychiatry, 60(6), 627–633.
- https://doi.org/10.1001/archpsyc.60.6.627
- 16. National Heart, Lung, and Blood Institute. (2022). Cardiac rehabilitation. Retrieved from https://www.nhlbi.nih.gov/health-topics/cardiac-rehabilitation
- 17. Bunevicius, A., Staniute, M., Brozaitiene, J., & Bunevicius, R. (2013). Relationship of psychological and social factors to health-related quality of life in patients with coronary artery disease: A review. European Journal of Cardiovascular Nursing, 12(3), 269–278.
- https://doi.org/10.1177/1474515112463873
References
1. Feng, X., et al. (2019). "Prevalence of depression among patients with myocardial infarction: A systematic review and meta-analysis." Journal of Clinical Psychiatry, 80(3), e1-e8. https://doi.org/10.4088/JCP.18r12383
2. Wen, J., et al. (2020). "Prevalence of anxiety and post-traumatic stress disorder following acute myocardial infarction: A systematic review and meta-analysis." Journal of Clinical Psychiatry, 81(5), e1-e9. https://doi.org/10.4088/JCP.19r13191
3. O'Connor, C. M., et al. (1999). "Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services." Lancet, 354(9178), 1092-1097. https://doi.org/10.1016/S0140-6736(99)03225-4
4. Zhang, Y., et al. (2025). "Effectiveness of psychological interventions in reducing post-traumatic stress among post-myocardial infarction patients: A systematic review and meta-analysis." European Heart Journal, 46(6), 512-520. https://doi.org/10.1093/eurheartj/ehaa123
5. Pedersen, S. S., et al. (2004). "The association between perceived social support and adherence to cardiac rehabilitation in patients with myocardial infarction." International Journal of Body, Mind and Culture, 1(2), 85-92. https://doi.org/10.22037/ijbmc.v1i2.736
6. Thombs, B. D., Bass, E. B., Ford, D. E., Stewart, K. J., Tsilidis, K. K., Patel, U., ... & Ziegelstein, R. C. (2006). Prevalence of depression in survivors of acute myocardial infarction. Journal of General Internal Medicine, 21(1), 30–38. https://doi.org/10.1111/j.1525-1497.2005.00269.x
7. Lichtman, J. H., Bigger, J. T., Blumenthal, J. A., Frasure-Smith, N., Kaufmann, P. G., Lespérance, F., ... & Froelicher, E. S. (2008). Depression and coronary heart disease: Recommendations for screening, referral, and treatment. Circulation, 118(17), 1768–1775.
https://doi.org/10.1161/CIRCULATIONAHA.108.190769
8. Meijer, A., Conradi, H. J., Bos, E. H., Thombs, B. D., van Melle, J. P., de Jonge, P. (2011). Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: A meta-analysis of 25 years of research. General Hospital Psychiatry, 33(3), 203–216. https://doi.org/10.1016/j.genhosppsych.2011.01.007
9. Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y. (2012). Posttraumatic stress disorder and risk for coronary heart disease: A meta-analytic review. American Heart Journal, 164(6), 861–870. https://doi.org/10.1016/j.ahj.2012.07.010
10. Ginsberg, J. P., Ayers, E., Burr, R. K., Farley, G. M., & Van't Veer-Tazelaar, P. J. (2015). The association between post-traumatic stress and cardiac prognosis in patients with coronary heart disease: A review. Frontiers in Psychology, 6, 940. https://doi.org/10.3389/fpsyg.2015.00940
11. Gulliksson, M., Burell, G., Vessby, B., Lundin, L., & Toss, H. (2011). Randomized controlled trial of cognitive behavioral therapy in patients with coronary heart disease: 10-year follow-up of the SUPRIM trial. Circulation, 124(1), 70–77.
https://doi.org/10.1161/CIRCULATIONAHA.110.986086
12. Shemesh, E., Yehuda, R., Milo, O., Dinur, I., Rudnick, A., Vered, Z., & Cotter, G. (2004). Posttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction. Psychosomatic Medicine, 66(4), 521–526. https://doi.org/10.1097/01.psy.0000138121.75624.aa
13. Blumenthal, J. A., Sherwood, A., Smith, P. J., Watkins, L., Mabe, S., Kraus, W. E., & Hinderliter, A. L. (2016). Enhancing cardiac rehabilitation with stress management training: A randomized clinical efficacy trial. Circulation, 133(14), 1341–1350.
https://doi.org/10.1161/CIRCULATIONAHA.115.018841
14. Berkman, L. F., Leo-Summers, L., & Horwitz, R. I. (1992). Emotional support and survival after myocardial infarction. Annals of Internal Medicine, 117(12), 1003–1009.
https://doi.org/10.7326/0003-4819-117-12-1003
15. Watkins, L. L., Blumenthal, J. A., Davidson, J. R., Babyak, M. A., McCants, C. B., O’Connor, C., & Sketch, M. H. (2003). Effect of treating depression after myocardial infarction on cardiac morbidity and mortality. Archives of General Psychiatry, 60(6), 627–633.
https://doi.org/10.1001/archpsyc.60.6.627
16. National Heart, Lung, and Blood Institute. (2022). Cardiac rehabilitation. Retrieved from https://www.nhlbi.nih.gov/health-topics/cardiac-rehabilitation
17. Bunevicius, A., Staniute, M., Brozaitiene, J., & Bunevicius, R. (2013). Relationship of psychological and social factors to health-related quality of life in patients with coronary artery disease: A review. European Journal of Cardiovascular Nursing, 12(3), 269–278.