Long-term emotional consequences of in-hospital cardiac arrest and myocardial infarction

Objectives. Prevalence rates for post-traumatic stress disorder (PTSD) of 10% have been reported following myocardial infarction (MI). However, there has been little research conducted on the long-term emotional sequelae of cardiac arrest (CA). The present study provides new information in that regard. The research aims were: (1) to compare the prevalence and severity of emotional disability in survivors of CA with that of cardiac patients who suffered an MI but no CA, (2) to assess both groups for the symptoms of PTSD, and (3) to assess the validity of a self-report measure for PTSD with a cardiac population. Design. Case-control study. Method. Patients who suffered a cardiac arrest in-hospital (N = 27) were compared with patients who had an MI uncomplicated by cardiac arrest (N = 27), 9.6 (5.0) months following their index event. Each patient completed a series of questionnaires and a structured interview to ascertain affective adjustment, and PTSD symptoms and diagnoses. Results. (1) Most MI and CA patients reported high levels of emotional well-being and stability. (2) Five (19%) CA survivors and two (7%) MI survivors (ns) fulfilled DSM-IV criteria for PTSD when assessed by structured clinical interview (SCID). (3) There was relatively poor agreement between the interview and self-report diagnoses when identifying PTSD cases (kappa = .39). Conclusion. The significant minority of cardiac patients warranting diagnoses of PTSD has implications for their management and rehabilitation. Identification of these patients is an important step towards improving their overall health outcomes. The structured clinical interview remains the 'gold standard' for the identification of PTSD in cardiac patient populations.