People born with heart defects need lifelong mental health care, report says

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People born with heart defects are at higher risk for anxiety and mood disorders as children and adults and should have mental health support built into their routine health care, according to a new report intended to spur research into the lifelong effects of living with such heart conditions. .

The American Heart Association’s scientific statement – an analysis of the latest research – is “an urgent call to action” to integrate medical and psychological care for those born with heart defects and the first to summarize the psychological challenges and social issues they face. It was published Thursday in the journal AHA Circulation: Cardiovascular Quality and Outcomes.

People with congenital heart defects, or CHDs, have hearts or blood vessels near the heart that did not develop normally before they were born. Although most people with such problems survive into adulthood, they may need several surgeries and specialized care throughout their lives. More than 2.4 million people in the United States live with CHD.

“It’s completely understandable to have a psychological reaction to living with a congenital heart defect,” Adrienne H. Kovacs, president of the group that authored the statement, said in a press release. Kovacs is a clinical psychologist who specializes in working with people with coronary artery disease. “The condition presents many lifelong challenges and can include unexpected news – such as a person realizing they can no longer physically handle the demands of their job or learning that there are significant risks to pregnancy. “

Many have tremendous resilience in the face of such challenges, she said, but “at the same time, we want to normalize psychological reactions and increase the prevalence of psychological wellness care to help people with heart disease to live a full and healthy life. “

According to the statement, children with complex heart abnormalities are five times more likely to be diagnosed with an anxiety disorder in their lifetime. Yet only a small fraction of children with coronary artery disease are assessed or treated for mental health issues. About half of adults living with coronary heart disease are diagnosed with mood or anxiety disorders.

The statement highlights issues related to each stage of life. During infancy, babies can undergo painful or frightening medical procedures and be separated from caregivers for long periods of time. This can make them oversensitive to light and sound, cause eating or sleeping problems, or lead to developmental delays.

Additional hospitalizations and surgeries and the added responsibility of having to manage their health during childhood and adolescence can mean less time to play or go to school. This can lead to social withdrawal, anxiety, depression, anger and defiance. As teenagers, they may also stop following health recommendations or display risky behaviors.

Adults may experience new or worsening heart symptoms, repeated surgeries, or other heart problems as adults, which can lead to financial hardship or problems with insurance and family planning. This can lead to relationship problems, problems with education or employment, and worries about maintaining good health and the possibility of dying.

“Decades of research outline the psychological and social stressors and challenges that can present themselves throughout the lifespan of people with coronary artery disease,” Kovacs said. “It’s high time we moved beyond awareness to action and provided more resources and expert mental health care for people living with coronary heart disease.”

The statement suggests integrating mental health specialists into specialist CHD care teams; encourage self-care strategies such as relaxation techniques; and prescribing heart-safe drug therapy for anxiety and depression, if appropriate.

“We would like mental health assessment and support to be part of comprehensive care for all people with coronary artery disease rather than a special service that is only offered in certain locations or under specific circumstances,” said said Kovacs.

Two other recent scientific statements from the AHA addressed issues related to coronary artery disease. A March 2022 statement recommended support for children during the transition from pediatric to adult health care, and an April 2022 statement summarized the ways the social determinants of health influence coronary heart disease across the lifespan. of somebody. A 2011 statement addressed developmental delays and neurodevelopmental outcomes in children with coronary artery disease.

American Heart Association News mental health coverage is supported by Diane and Daniel Shimer. AHA News is solely responsible for all content and editorial decisions.

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