Dr. Gillinov’s Video Blog: “How Can Patients Identify, Prevent And Treat Cardiac Depression?”

By Adam Pick on February 10, 2011

Since writing my book and launching this website, I have been very fortunate to meet some amazing people. One such person is Dr. Marc Gillinov of the Cleveland Clinic. Not only is Dr. Gillinov an incredible surgeon but he is a patient advocate and a proactive supporter of our community.

That said, I was thrilled to interview Dr. Gillinov about the important — but sometimes overlooked — topic of cardiac depression. As I personally experienced, cardiac depression can be an unexpected and unnecessary pitfall during the recovery from heart valve surgery.



To learn more about Dr. Gillinov and read several patient testimonials for Dr. Gillinov, please click here. Finally, to help those patients and caregivers who are hearing impaired, I have provided a video transcript below:

Adam:  Hi, everybody.  It’s Adam and I’m here at STS in San Diego with Doctor Marc Gillinov and, as you know, we’re answering your questions that you posted on my blog and we have a very important question, I think, because I experience it related to cardiac depression and the question for Dr. Gillinov that came in was about what from a surgeon’s perspective would you use to identify somebody experiencing cardiac depression and then what would you suggest to the patient and their caregivers to treat that problem.

Marc Gillinov, MD:  That’s an important question because if you fix somebody’s cardiac problem but they feel bad for other reasons, for example they’re severely depressed, that’s not a victory. The first thing to know about cardiac depression is that it is not normal.  Some people might say, “Well, of course you’re depressed.  You’ve got heart problems.  You had heart surgery.  Don’t worry.  It will go away.”  Hogwash.  It’s not normal.  You’re not supposed to be depressed but 20 to 25 percent of heart patients, whether it was surgery, angioplasty, heart valve surgery, or even medicines get depressed. How do you know if you’re depressed?  If you are feeling lack of energy, lack of interest, you just don’t want to do anything, things that interested you before — from before just don’t even make you get off the couch, you might be depressed.  In addition, if you’re really depressed and you’re having thoughts about harming yourself, then you’re for sure depressed.  One of the problems is a lot of people don’t recognize it themselves.  They might think, “Well, I don’t feel so well.  I don’t have much energy because I’ve got something going on with my heart.”  Therefore, it’s really important for the family to help out.  Your husband, your wife, your brother, your sister, your kids, they might pick it up.  And before your heart surgery or soon after you’ve had heart issues, have this discussion with your doctors.  Ask, “Is depression a possibility here?  Should I be on the lookout for it?”  And have someone in the family present for that, too, because, again, you might miss it.  And then, what if you get depressed?  What if you have this lack of interest, lack of energy, feeling down?  Don’t take the common advice which is “Don’t worry.  It’ll go away.”  Do nothing.  You need to do something.  What can you do for it?  Exercise.  I know it’s tough to get up, especially if you’ve just had heart surgery, but exercise is one of the single biggest things.  In addition, if you have cardiac issues or you’re a cardiac patient or you’ve had heart surgery, definitely do cardiac rehab. I know.  I’ve read about this in your blog.

Dr. Marc Gillinov:  And how much it helped you.  It helps everyone.  Being around other people, learning about their experiences, realizing you’re not alone, again exercising, those things can help prevent depression and it can help treat it.  And finally, if you’re still feeling down and you’re still feeling bad, see a psychologist because medical condition or a psychiatrist.  There are medicines to treat it, but I think the most important thing is recognizing it happened.  Don’t ignore it and fix it if it occurs.  We all know it’s out there.  Fix it.  You don’t need to be depressed.

Adam:  Great.  Well, I just want to thank you for taking the time…

Dr. Gillinov:  Oh, I’m into this.

Adam:  As you know this — I experienced cardiac depression so hearing you talk about it, I’m sure it’s not only educational for me but for all the patients and their caregivers out there, this is something that should definitely be tracked as the patient is recovering from not just heart valve surgery but any type of procedure, so thanks again.  This is Dr. Marc Gillinov from the Cleveland Clinic.  You can learn more about him and his specialties at HeartValveSurgeons.com.  Thanks so much.

Keep on tickin!

Written by Adam Pick
- Patient & Website Founder

Adam Pick, Heart Valve Patient Advocate

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

John Ure says on February 10th, 2011 at 6:13 pm

Thank you for the above and all the other useful information you provide. I have Mitral regurgitation but the Cardiac Surgeon says it is only a mild leakage of the Mitral valve and my main symptoms are attributable to poor left ventricular function. I have recently had an angiogram and it was all clear. I am due to see my Cardiologist again on February 25. However, I also have atrial fibrillation which is my main concern and I am arranging to see an Electrophysiologist to possibly have an AF ablation to fix it.
However the main reason for my email is that my wife and I do a lot of travelling all over the world and, of course, I have to be prepared for any health emergency, particularly outside Australia. I have therefore put all my medical records on a USB flash drive, stuck a label it with my name and the words “Medical Records”. I have attached a cord so that it can hang around my neck, that way if I am in an accident or become unconscious, it may greatly assist medical personnel in providing swift and effective treatment. Particularly important if you are an older person and/or have a potentially serious medical condition, such as High Blood Pressure, Heart disease, Diabetes or Asthma. Because it contains very personal and important information, I get into the habit of wearing it whenever travelling and take special care not to lose it. This simple thing may save my life.
Regards John Ure

Ed Rutkowski says on February 10th, 2011 at 9:04 pm

It was great to see Dr. Gillinov. He is indeed an extraordinary surgeon who robotically repaired my mitral valve and a-fib issues last April. While a 25% incidence rate of depression was cited as a statistic following heart valve surgery, I just wanted to comment that from personal experience there is another possible side to that coin. A number of articles I have read speak to an association between mitral valve prolapse and depression. For years before my surgery I was prescribed an anti-depressant. In my case, my surgery not only addressed the “plumbing” issues that Dr. Gillinov mentioned, but also all but removed those feelings which required the anti-depressant. I am very happy to report for example that my valve repair has facilitated some swimming early in this morning and a spin class at lunch time, with a full day of work in the office, but as has been the case since my heart valve surgery, no longer included taking any anti-depression medication.

I hope I am not the only one to have these results and just wanted to say that though anticipating heart surgery and the required rehab is daunting, having the opportunity for a new lease on life for me has proved to be an energizing rather than a depressing experience.

Thanks, Adam for all your dedication to addressing issues of concern to those with heart valve issues. And my special thanks to Dr. Gillinov and the other folks at the Cleveland Clinic!

Don Spencer says on February 11th, 2011 at 10:16 am

Hi Adam, the picture of me and Dr. Gillinov was taken on my day of discharge from the Clinic, 4 days after my open heart Aortic valve surgery. You would have a hard time finding a nicer more gifted surgeon than Dr. Gillinov. Next week is my 1 year anniversary with my new valve.

Don Spencer

Adrian B. says on February 13th, 2011 at 10:34 pm

Great info as usual. This response is particularly for John Ure. I appreciated your suggestion re transporting your records. I used to live on a small island and travelled a lot, especially to Africa where cardiac surgery facilities are few and far between. My wonderful surgeon, Dr Louis Kanda at Washington (DC) Hospital Center, himself a Congolese, recommended that I not use a mechanical device for my valve replacement, but instead go with a bio-vlave. His biggest reason was that if the mechanical device ever failed, I would need expert care immediately, whereas when a bio-vlave fails, it goes gradually, similar to my original home-grown valve. In his experience they have a not-much shorter life expectancy, and are easier to work with down the stretch. So I do not know what your future may hold, but ask questions about “what happens when it fails” if surgery becomes a path for you.

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