Mental health support is an integral part of treating patients with heart defects, AHA says

A recent American Heart Association (AHA) scientific statement expressed the need for more mental health support to be integrated into routine healthcare for those with congenial heart defects.

The scientific statement, designed to inform future guidelines through expert analysis of current research, was published in the journal, Circulation: Cardiovascular Quality and Outcomes. According to the paper, congenial health defects (CHD) are a result of structural abnormalities of the heart or heart related blood vessels. Oftentimes surgical intervention is required for patients with CHD and most patients survive through adulthood. However, according to the AHA, surgery does not cure heart defects and continued mental and physical care is needed throughout the patient’s life.

“Decades of research describes the psychological and social stressors and challenges that can present across the lifespan for people with CHD,” said Adrienne Kovacs, PhD, chair of the writing committee for the scientific statement and a clinical psychologist who specializes in working with people with CHD. “It’s long overdue that we move beyond awareness to action and providing more resources and expert mental health care for people living with CHD.”

According to the statement, children with complex CHD are five times more likely to be diagnosed with anxiety disorders than children without CHD, yet only a small fraction of children with CHD receive mental health assessments or treatments.

To explain how CHD can affect a patient throughout their lifetime, the statement listed psychosocial impacts of the condition during the various stages of life, including:

• Infancy: As a result of intense procedures babies may have hypersensitivity to light and sound, difficulty sleeping and feeds, display signs of distress, and experience developmental delays.
• Childhood: Additional hospitalizations and surgeries may cause children with CHD to become socially withdrawn, present symptoms of anxiety and depression, display aggression or hyperactivity, and have difficulty in school.
• Adolescence: As CHD patients transition from childhood to adulthood, they often crave more independence concerning the management of their health. This can cause social difficulties, frustration, defiance, and anger.
• Adulthood: Worsening heart problems can lead to problems with finances, employment, insurance, and family planning, causing stress and anxiety.

According to the AHA, improving the mental health of CHD patients could involve encouraging the use of relaxation techniques, support groups, psychotherapy, and in some cases, heart-safe medications for anxiety and depression.

”The goal of this statement is to foster psychologically informed care that empowers people with CHD and their families and provides emotional support,” said Kovacs. “We would like mental health assessment and support to be part of comprehensive care for all people with CHD rather than a special service that is offered only in some places or special circumstances.”