Cardiovascular Health

Heart Disease and Mental Health

Heart disease and mental health can influence one another. Mental health conditions are associated with cardiovascular risk through biological and behavioral pathways. Depression, anxiety, and post-traumatic stress can also develop after a cardiac event^[2][2].

Mental health symptoms can make physical activity, stopping smoking, and following a medication plan more difficult. Support that addresses both physical and mental health can help; these challenges should not be reduced to a lack of willpower or coping skills^[2].

A heart diagnosis or cardiac event can bring worry, sadness, or anxiety. Tell your healthcare team if these feelings persist or affect daily life. Emotional support and appropriate mental health care can be part of recovery^[3].

Subject matter expert

Samantha Pieterse

Psychiatric nursing and mental health care

What Causes Heart Disease?

High blood pressure, high cholesterol, and smoking are important heart disease risk factors. Other factors include age, family history, diabetes, excess body weight, physical inactivity, and diet. The list below describes factors to discuss with a healthcare professional^[4][4].

• Age—older people have a higher rate of diagnosis
• Family history
• Diabetes
• Excess body fat
• Diet high in highly processed food, trans fats, sodium, and sugar
• Lack of physical exercise
• Drinking too much alcohol

What Are the Symptoms of Heart Disease?

Heart disease symptoms vary, depending on the specific illness and the individual's medical history. Examples of cardiovascular diseases include:

• Coronary artery disease ^[1]
• Congenital heart defects ^[5]
• Arrhythmia
• Dilated cardiomyopathy
• Myocardial infarction
• Heart failure
• Hypertrophic cardiomyopathy
• Mitral valve regurgitation
• Mitral valve prolapse
• Aortic stenosis

Individuals with heart disease might not experience any symptoms until the condition becomes serious. High blood pressure and high cholesterol should be managed with the help of a medical professional as a preventative measure against life-threatening conditions such as heart attack, arrhythmia, and heart failure. Symptoms are listed below:

• Heart attack: Heartburn, nausea, vomiting, chest pain, neck pain, extreme fatigue, dizziness, difficulty breathing, and dizziness
• Heart failure: Trouble breathing, swelling due to water retention (edema), and fatigue
• Arrhythmia: Fluttering sensations in the chest

How Is Heart Disease Diagnosed?

Diagnosis depends on symptoms, medical and family history, risk factors, and test results. A clinician may recommend an electrocardiogram, stress testing, imaging, or coronary angiography. The appropriate sequence depends on the clinical situation; an abnormal stress test is not always required before angiography^[6].

• Exercise stress tests: Clinicians assess how the heart responds to exercise, sometimes using ECG monitoring and imaging^[6].
• Pharmacologic stress tests: When exercise is not suitable, medicines can be used to assess the heart’s response under stress^[6].
• Coronary computed tomography (CT) angiography: CT images taken with contrast dye help clinicians examine the coronary arteries for narrowing or plaque^[6].

How Is Heart Disease Treated?

Treatment depends on the condition and may include medicines, lifestyle changes, procedures, or surgery. Not everyone needs all of these treatments^[1].

• Anticoagulants that thin the blood
• Antiplatelet therapies can prevent clotting
• Beta-blockers lower blood pressure and reduce heart rate
• Calcium channel blockers prevent arrhythmia and lower blood pressure
• Cholesterol-lowering medications reduce low-density lipoprotein cholesterol
• Diuretics remove excess water from the body and reduce the heart's workload
• Vasodilators relax blood vessels and lower blood pressure

Cardiac rehabilitation is a medically supervised program that may include exercise training, education, and counseling. The care team tailors activity and support to the person’s condition:^[7]

• Regular physical activity
• Education and support regarding a heart health-promoting diet, taking medication on time, and quitting smoking
• Stress reduction
• Counseling to stay mentally healthy and manage symptoms of depression and/or anxiety

How to Cope with a Heart Disease Diagnosis

Ongoing medical care, prescribed treatment, and suitable lifestyle changes can help manage heart disease and reduce complications. Outcomes depend on the condition; not every heart disease can be cured or brought into remission. Your care team can help you plan changes and find support^[8].

How to Help Someone with Heart Disease

When someone receives a diagnosis of heart disease, it can be highly distressing and disorienting for them and their loved ones—and there's no invalid reaction. To help them, maintain positive communication, support them as they work toward a healthier lifestyle, encourage them to attend treatment, and work together to reduce stress at home.

If a family member experiences anxiety, depression, or distress and feels unable to cope, they should consider seeking counseling for themselves. Family therapy can also be helpful. When everyone actively manages their emotional state and tries to be mentally and physically healthy, it can have a deeply positive impact on the individual with the diagnosis.