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Post Traumatic Stress Disorder: Beyond the Battlefield

By Nadine Salmon, MSN, BSN, IBCLC, Clinical Content Specialist AMN Healthcare

Enduring a myocardial infarction (MI) is a traumatic enough experience in itself, but researchers have now found an elevated incidence of Post Traumatic Stress Disorder (PTSD) in survivors of such life-threatening medical events.

PTSD sufferers periodically relive the trauma of a past event, which causes them to avoid places, people, and reminders of a traumatic event, and often leads to a hypersensitivity to normal life experiences (Davydow et al., 2008). Traditionally, healthcare professionals associated PTSD with war veterans. We now need to expand this definition to screen for PTSD in adults who endured a life-threatening medical condition.

PTSD has been recognized as a formal diagnosis since 1980, and statistics indicate that approximately seven to eight percent of people in the United States will likely develop PTSD in their lifetime (MedicineNet, 2012). An estimated 5 million people suffer from PTSD at any one time in the United States, and women are twice as likely as men to develop it (MedicineNet, 2012). In addition, a recent meta-analysis found that one in eight patients may develop PTSD after a heart attack or unstable angina (Phend, 2012).

According to Donald Edmondson, PhD, of Columbia University Medical Center in New York City, the likelihood of another life-threatening medical event or death occurring is doubled in patients suffering from acute coronary syndrome (ACS)-induced PTSD. Dr. Edmondson and his colleagues caution that the studies conducted were fairly small and examined outcomes over a limited period of time. A larger observational cohort study is needed to identify risk factors for PTSD after a coronary event and explore the exact mechanism for the development of PTSD. Current hypotheses suggest that a possible elevation in the body’s inflammatory response may be the common link between ACS and PTSD (Phend, 2012).

In the meantime, it is advisable for healthcare professionals to utilize the four-question Primary Care Screening Tool for PTSD, which is available online through the VA's National Center for PTSD.

References: 

Davydow, D., Gifford, J., Desai, S., Needham, D. & Bienvenu, O. (2008). Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. General Hospital Psychiatry, 30 (5), 421-434.

MedicineNet.com. (2012). Posttraumatic Stress Disorder (PTSD). Retrieved from: http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm 

Phend, C. (2012). MedPage Today. Post Traumatic Stress Disorder Not Unusual After MI. Retrieved from: http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/33381?utm_source=cardiodaily&utm_medium=email&utm_content=aha&utm_campaign 

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