Author(s): <p>Mounika Chinta, Hari Manasa and Suresh Kumar Kota*</p>
Background: Anxiety is commonly experienced among patients with cardiovascular disease. Psychiatric disorders such as depression and anxiety, represent an additional risk for cardiovascular disease besides contributing to impaired functions. To date, depression has received the most attention in the population, given its high prevalence and association with poor cardiac health, especially in patients who have experienced a major cardiac event, such as an Acute Coronary Syndrome (ACS). However, anxiety has recently emerged as another important psychological construct that is highly prevalent, frequently co-occurs with depression and impedes response to depression treatment, and may ultimately influence the course of cardiovascular disease independent of depression.
Objectives: To assess the prevalence of anxiety among patients diagnosed with cardiac disorders.
Methods: A cross sectional study was done among 100 cardiac patients. A self-designed semi structured questionnaire consisting of demographic details, relevant cardiac and psychiatric history and General Anxiety Disorder (GAD-7) scale was used. The obtained data was entered in MSexcel and analysed using SPSS software.
Results: 43% patients were recognised to have anxiety. Among them 21% had mild anxiety, 12% had moderate anxiety and 10% had severe anxiety. A significant association of 0.002 was found in females having cardiac illness. A significant association of 0.043 was found between coronary artery disease and anxiety.
Conclusion: These analyses confirm that anxiety is associated in patients with cardiac disorders; however, this relationship is not as strong as that of depression and may be explained partly by other clinical factors.
The Association between psychiatric disorders and cardiovascular disease (CVD) has received growing attention in recent scientific literatures. Psychiatric disorders such as depression and anxiety, represent an additional risk for Coronary Artery Disease (CAD) Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation)and health behavior mechanisms may help to explain the relationship between anxiety disorders and cardiovascular disease [1,2].This linkage between anxiety and Cardiovascular disease is further corroborated by evidence suggesting that treatment of anxiety may improve cardiac symptoms [3]. A Danish survey found that 25% of patients with cardiac disease experienced symptoms indicating anxiety and that anxiety was associated with an increased risk of death [4]. Prevalence of anxiety disorder in coronary artery disease reaches upto 15% and about half of patients with coronary artery disease have comorbid anxiety or depression [5]. A history of stress exposure increases the pathophysiological response to ischemia and anxiety-like behaviour, whereas inhibiting microglial activation reduces neuronal damage and mitigates the development of anxiety behaviour after cardiac arrest [6].
To study the prevalence of anxiety in patients diagnosed with cardiac illness.
The present study showed that the prevalence of anxiety in patients with cardiac disorders was 43%. Among 43%, 21% had mild anxiety,12% had moderate anxiety and 10% had severe anxiety. A significant association of 0.002 was found in females having cardiac illness. A significant association of 0.043 was found between Coronary Artery Disease and Anxiety. Among various cardiac disorders 55.3% patients of Coronary Artery Disease (CAD) had anxiety,25% patients of Myocardial Infarction (MI) had anxiety,33.3% patients of Angina had anxiety and 26.3% patients of other cardiac disorders had anxiety. Meeri Koivula et al and colleagues, in their study first to examine fear and anxiety of coronary artery bypass patients at different time points, in the coronary artery bypass process and changes between different time points [7]. The highest levels of fear and anxiety were measured in the waiting period to Coronary Artery Bypass Grafting (CABG). Tove Aminda Hanssen et al and colleagues, in their study of acute myocardial infarction reported 19.7% and 13.6%, high levels of anxiety and depressive symptoms, respectively. At baseline, acute myocardial infarction patients were more anxious, but not more depressed, when compared with the reference population(P<0.001 and P=0.092,respectively) [8].Jeff C Huffman et al and colleagues, in their study they found that 25% of patients with chest pain who come to hospital emergency departments have panic disorder [9].According to study done by Erika Friedmann et al and colleagues, there is a high prevalence of anxiety and confirms the high prevalence of depression in the heart failure outpatient population [10]. Katherine Easton et al and colleagues, in their study there is a prevalence of 13.1% for anxiety disorders, 28.79% for probable clinically significant anxiety and 55.5% for elevated symptoms of anxiety was identified [11].
Type of Study: Cross-sectional study
Ethics Committee: Approval was taken from the ethical committee of the institute
Study Setting: Katuri Medical College & Hospital, Guntur, Andhra Pradesh
Study Period: June 2022- September 2022(3 months)
Sample Size: 100
Sampling Method: Convenience Sampling
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