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Heart Disease and Depression
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ProudNana3 posted:
In October it will be 2 years since I had 2 stents in my Coronary Arteries, and diagnosed with CAD. Recently I have started worrying about my "mortality" and wondering if and when will I have more problems, or how long will my stents last. I am so aware of my heart, and if I have the slightest "twinge", I start getting panicky.

I was just last seen by my Cardiologist, and he was very pleased with me, and doesn't think I need to see him for another year. I know I am worrying way too much, but am wondering if anyone else with heart disease seems to be more aware of their heart than they were before being diagnosed, and would this be considered depression?
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CardiostarUSA1 responded:
Hi:

"Would this be considered depression?"

No, more like a heightened sense of awareness, which has been reported by some individuals with coronary artery disease (CAD).

For good general info on depression, see -

eMedicine Health

www.emedicinehealth.com/depression/article_em.htm

.

As applicable, depression is common, happens in many individuals, especially after a heart attack, or a heart procedure (e.g., angioplasty/stents or bypass surgery), and depression often can be effectively treated and defeated (sometimes with the help of professional counseling).

Also, sometimes, anger, mood swings/emotional outbursts/emotions running wild can occur, personality changes (which sometimes can be directly due to prescription drugs or even brain damage from a stroke that occurred during or right after heart surgery which can cause neurological alterations or deficits), and fear as well.

Additionally, one may even feel hopeless or has decided to give up, throw in the towel so-to-speak. In many cases, it self-resolves in a reasonable period of time.

About coronary stents

Bare-metal or drug-eluting stents lasts in the artery for the life of the patient. After implanted, the stent is gradually incorporated (new tissue grows over and through the struts, drug-eluting somewhat delays this, hence possible blood clot problems) into the vessel wall, essentially becoming a permanent part of it.

The drug contained on a drug-eluting stent, which is gradually released, and the polymer coating that gradually releases it, only lasts for a limited period of time, as is designed to, is intended to do so.

Sometimes though, a problem can occur at the stented site, such as restenosis (renarrowing, in some cases, even with drug-eluting stents), or new or accelerated atherosclerotic plaque buildup, requiring another angioplasty and possible re-stenting or "stent sandwich" (placing a stent within a stent).

Most important, CAD is a life-long unpredictable condition (can exhibit periods of stabilization, acceleration, and even some regression), requiring a continuum of top notch care, as well as good doctor-patient, patient-doctor communication and understanding at ALL times.

ALWAYS be proactive in your health care and treatment. Best of luck down the road of life. Live long and prosper.

Take care,

CardioStar☆

Advocate for ♥-Health

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☑Be well-informed

WebMD

Living With Coronary Artery Disease (CAD)

A chronic disease with no cure. When you have coronary artery disease, it is important to take......

This is especially true if you have had an interventional procedure or surgery to improve blood flow to the heart....../It is up to you to take steps......

Recognize the symptoms. Reduce your risk factors. Take your medications. See your doctor for regular check-ups......

www.webmd.com/heart-disease/guide/living-with-heart-disease

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Good to know, for the primary/secondary prevention of heart attack/brain attack

Epidemiologic studies have revealed risk factors for atherosclerosis (typically affects coronary, carotid, peripheral arteries), which includes age, gender, genetics (gene deletion, malfunction, or mutation), diabetes (highest risk factor), smoking (also secondhand), inactivity, obesity, hypertension, diet high in fat, saturated fat and cholesterol, high LDL, high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine, and high C-reactive protein (CRP/hs-CRP).

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Quote

"Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

.

It's your future......be there.
 
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ProudNana3 responded:
Thank you so much for your answer, as it really did help me. Yes, I do seem to have a heightened sense of awareness concerning my heart. Not sure if this is good or bad, but it's certainly something that I am going to have to either get used to and or learn to live with, or totally ignore it. I think most of this stems from the fact that I have 3 grandchildren under the age of 8, and since they are the lights of my life, I want to be around a long time for them. Therefore, I think about my heart health all the time.

Again, thanks so much for answering me.
 
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metabolicwreck responded:
I know that depression is different for everyone. But, mine manifested in the months immediately following my heart attack, when I would wake up in the morning crying. And, for awhile, I was terrified of anything that increased my heart rate. But, it gradually got better, and I'm proud of myself that I learned to assess my "twinges" and I actually only went to the ER once with chest pain, and that was nearly 4 years following my heart attack and stent placement.

So, I guess what I'm saying is, hang in there. And, when you have those twinges (that always seem to happen!) evaluate whether it feels anything like previous pain, and is it triggered by activity, and does it respond to nitroglycerine. Gather your little bits of information, and if it's really telling you that there is something wrong, don't hesitate to get to the ER--better safe than sorry. But, I do think that you can probably identify how critical it is, and don't worry so much about the occasional pain upon waking up in the morning. After all, you probably had those when you were 30, and didn't think anything about it. And, it does get easier the further out you get.

Good luck--and hang in there.

The Wreck
 
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chuck_5112 responded:
ProudNana3, I am a 34 year old male. I had a cardiac MI on April 24, 2008. I completely understand how you feel. Every twinge, every skipped beat, every day I think it is happening again. I can tell however, it is getting alittle easier day after day to keep going and to take my mind off of my heart. I had an episode of syncope(fainting) while taking Niaspan and had to wear a monitor for 45 days. That was my security blanket until they discovered a sinus pause while I was sleeping; at first the docs said pace-maker then they tested for sleep apnea and you guessed it; I have that too. I would rather wear that mask than a pacemaker any day. I think the key is to always look forward to something. I have to kids 8 and 3, they always give me something to live for. Judging by the screen name I bet you have the same with your grand-children. I think the best thing that came out of my heart attack is that I along with my family found our way back to church (not preachin just sayin). The more I stay busy the less I worry. Hang in there chuck_5112
 
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MrC_MIx2 responded:
I'd like some more info on this subject. I've had 2 heart attacks. One on Nov. 23, 2005 and my second on Jan 11, 2009. I have 14 stents. 7 from first MI, 4 from 2nd, 2 more in March of '09 and one yesterday. My first "stent sandwich." I've been to the ER roughly 20 times since Jan 11 this year. I tolerate a lot before calling 9-1-1. I near always get treated and released for "atypical chest pain" caused by anxiety. Problem is I don't get anxious until I start getting moderate chest and arm pain, and sometimes pain in my neck and throat. Now I'm being told that I need to start taking Paxil for depression. I don't feel depressed at all. I just don't feel like I'm getting well. I exercise plenty, have a nature photography hobby, HAM radio, ---- My son and daughter still live with me and are a great help, have a dog I love bringing to the park----

Most of the time I'm treated well in the ER but I know that certain docs and nurses don't like seeing me so often. Rude comments, rolling of eyes, etc. --- Make me feel guilty for feeling like I'm about to die and for seeking medical treatment. --- I'll be released tomorrow after just having another angioplasty without having the opportunity to speak with a cardiologist. Had a 'Hospitalist" speak with me today about taking Paxil. I don't want to take it. Xanax works a little bit and I'm only taking that to make the docs happy. Anyway I told the hospitalist my concerns about taking such medications. They're all poison to me. I'll take my heart meds without question. I know I'll die without them. Told her I have 14 stents and she refused to believe me even after offering to show her all the cards I carry in my my wallet for each and every stent except for the one I had placed yesterday. I'll get that card tomorrow. She refused and said she'd check my records. I asked her how many anti depressants and anxiety meds she took and she said none because she'd found other ways to deal with her problems. Then she got mad at me and ended the conversation. So I'm not sure what I want to do. I'm not denying I have anxiety issues when I start with what I perceive to be cardiac related pain. I admit to having crying spells every once in a while but I don't at all feel depressed. No energy? Yes. Depressed? No. So what do I do? Cave to the docs? Or try the poison and stop if I don't feel any better? Or just be true to my feelings and not take it all and have the doctors label me as "non compliant"?
 
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manegro responded:
ProudNana3 you should not worry that much if your doctor said that its ok, to visit him in a year..u have nothing to worried about..

Also who to this page maybe it can help u out.
 
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Byroney_WebMD_Staff responded:
Dear MrC_Mix2,

Seeing a psychologist or psychiatrist is a very good idea--remember, there are many ways to address anxiety issues (if you have them), other than with medication. That's just one 'tool' in the doctor's toolbox.

I would suggest that you speak to the hospital administrator or patient rights advocate about the treatment you received from the hospitalist. It sounds like she was unprofessional and did not in any way help you.

Yours in health,

Byroney
 
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luvblue responded:
I am sitting here having some chest pain & wondering...again! I did have a heart attack in June '09 yet was told I was fine by my Cardiologist & to come back in a year.

A long time before the heart attack, I had the same kind of chest pains. I was..& am..very stressed out & have been treated for depression & panic attacks in the past. I'm not sure the chest pains I'm having are more 'panic attacks' or depression..or really heart problems? The pains I'm having right now have been bothering me almost all week! I can't help but take aspirin & even took nitro sub-linqual last night. They still continued.

I'm a widow & live alone. I feel I just have to much time on my hands & to much time to 'just worry'. My actual heart attack was caused from circumstances that led to very high stress. I plan to make an appointment with a therapist ASAP! The first time I had panic attacks, I was unable to drive. With help, I got over that pretty much.

To answer ProudNana3...I certainly am more aware of my heart than before. Prior to my heart attack, when I got stressed out & would get the exact same type of chest pains, I blew them off as 'stress'. I so wish I could do that now.

Another poster mentioned going to the hospital so much..folks there seemed to not be taking her seriously..(my words, not theres). I feel if I went to the ER every time I go through these episodes, the same thing would occur.

Any advise to maybe help me relax? Luvblue
 
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DeadManWalking56 responded:
I "merely" have extreme blockages, and the past three years the only thing giving me significant chest pain is any fatty food.

So I eat very healthy, very low fat, plenty of anti-oxidant rich foods, and try to get some walking or other more vigorous exercise everyday.

I have to avoid things that may excite me, like exciting movies. I can't get excited watching sports as I used to. Interested detachment.

Even light exercise helps alleviate depression, and reduces inflammation throughout the body through production of cytokines by the regular movement of skeletal muscles. If you move more, you heal. As you start to heal, you feel better and are less depressed.

Don't worry, be moving. Don't worry, be eating healthy. Get someone else to do these things with you. You'll both feel better and be happier.

DMW
 
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scottishwannabeladay responded:
Hi,
I'm sorry you're going thru this, please you are not alone My case is a little different from yours, I had 5 stents put in 8 months ago and ever since I have suffered and still do severe depression and crying spells. I also am very aware of my heart every minute of the day just like you are. More research needs to be done on this. I am so glad I am not alone in this. They need to find out why this happens. I hope you are hanging in there, please do.


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