In the past, we have had several discussions about cardiac depression as a common, patient pitfall after heart valve surgery. Now, it appears there is some new evidence which suggests that treating depression may help treat patients after a cardiac event.

Sarah sent me this very interesting article which was recently featured in The Wall Street Journal.

Patients who develop depression after heart attacks fare worse in the long term than those who don’t. But will treating their depression prevent further heart problems and safe lives? That question plagues medical experts and is a source of fresh contention among cardiologists and behavioral scientists looking for effective strategies to help patients suffering from both conditions.

Depressed people are more likely to have heart attacks, and 15% to 20% of those who have had heart attacks get depressed, according to the American Heart Association. In contrast, 6.7% of adults in the overall U.S. population will be become depressed any given year, according to the National Institute of Mental Health.

Classic-car lover Nicholas Toros says that he couldn’t enjoy his hobby after a heart attack in 1991 led to bouts of depression.

Moreover, depressed heart patients have a greater chance of dying and a worse quality of life compared to those who aren’t depressed. A study published Monday in the Archives of General Psychiatry found that patients who developed severe depression after being hospitalized for a cardiac event, and remain depressed for at least six months, had more than double the risk of dying over the next seven years.

“The bottom line is that depression is important,” says Brett Thombs, assistant professor in psychiatry at McGill University and Jewish General Hospital, Montreal. “The question is what we do about it.”

Remedies for depression in the general population include antidepressant medications, such as Prozac, that have transformed treatment of the condition in the past two decades, and psychotherapy. But there is surprisingly little research examining whether these approaches help prevent deaths or heart attacks among heart patients who also suffer from depression.

In a move that continues to spur debate, the American Heart Association came out with recommendations last year stating that all heart-disease patients should be screened for depression, and those with symptoms should be treated. The guidance, endorsed by the American Psychiatric Association, was issued even though both organizations acknowledged a lack of evidence that such screening improves outcomes in patients with heart disease.

To learn more about cardiac depression as it relates to heart valve surgery, please click these links:

• Behavioral and Emotional Changes After Heart Surgery
  
• How To Care And Support A Heart Valve Surgery Patient?
• Heart Surgery Patients Should Not Feel Alone & Isolated
• Vicodin And Heart Surgery Recovery… Beware!
• Recovery Tip: Go To Cardiac Rehab
• Heart Valve Surgery & Cardiac Depression – My Experience

Keep on tickin!

I just received a great patient story from Annette about asthma and heart valve disease.  Here is what she writes:

Don, my husband, had his aortic valve replaced with a cow valve and his mitral valve repaired on July 21, 2009.  Prior to the surgery, Don suffered from severe asthma. His situation was so bad, eleven years ago, we moved from Illinois to Florida in hopes of helping his bad asthma. Unfortunately, the move did not help.

Don Houdek – Double Heart Valve Replacement Patient

Well… Don and I are happy to report that – since his heart valve surgery – he has not taken any asthma medicine. At check-ups, Don’s lungs are showing up “clear” when the doctor listens to him.  I have to admit, this was one of the best perks of having his heart valves repaired and replaced.

Thanks so much for your heart surgery book which relieved our anxiety!

Regards,
Annette Houdek

P.S. To leave a comment, please click here.

I just received a fantastic, patient update from Anita. As you can read below, Anita is hiking and camping just six months after mitral valve repair surgery. Here is what Anita wrote to me:

Hi Adam,

As you may remember, I had mitral valve repair at The Cleveland Clinic on March 30, 2009. Doctor A. Marc Gillinov was my surgeon.

I am doing great. In fact, last weekend, Mike and I visited the Adirondack Mountains near Lake Placid, New York. The journey (hiking, camping, climbing) was magical.

Anita, Heart Valve Surgery Patient, With Mike

I climbed two of the “High Peaks” which required us to hike uphill for two miles as we reached a 3,800 foot elevation.  Each of the peaks had spectacular views at the top. I felt so happy and so grateful to see the all of the beauty that was present.

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I just received a roller coaster email from Sarah about endocarditis, swine flu (H1N1 virus) and heart valves that made my head spin. In the end, Sarah raises some great points for patients and caregivers about endocarditis, swine flu, fevers, false tests and dental work. Here is what she writes:

Adam,

I just returned from a very scary 36 hours that landed me in the hospital with fears of endocarditis.

Last Friday, I called my primary care doctor because I had been fighting a cough, congestion and fever for over a week. She did a quick test for the flu, it came up negative. I told her that I had dental work to put on a crown about 10 days earler, two days before the fever started. Well, that set up a red flag for the possibility of a heart valve infection (endocarditis) even though I had used amoxicillin as advised by my doctor before the dental work.

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Like many patients, I found that heart valve surgery brought about a unique, introspective view of life.

That said, when I run across something that really makes me stop and think, I like to share it in this blog for your consideration. Sometimes these little stories, pictures and jokes help offset the seriousness of a topic like heart surgery.

Regina Brett – Columnist For The Plain Dealer

So, here is a great column from Regina Brett. If you didn’t know, Regina writes for The Plain Dealer in Cleveland, Ohio. She also hosts a show on National Public Radio.

Recently, Regina turned 50 years old. She celebrated that milestone by documenting her life lessons. Needless to say, I found a lot of value in these very appropriate, words of wisdom. Here are Regina’s life lessons:

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