For cardiac patients of any age, mental health care is crucial

Although they may experience a range of health-related psychological and social challenges throughout their lives, many people who are born with heart abnormalities are resilient and enjoy a wonderful quality of life.

The forms of mental health care that may be helpful are discussed in a new scientific statement that examines potential psychological and social difficulties that may arise from childhood through adulthood among people born with heart abnormalities. The declaration urges interdisciplinary teams that treat children and adults with congenital heart abnormalities to include mental health practitioners. This is more typical in cancer care than cardiac care.

People who are born with anatomical abnormalities of the heart or the blood arteries affecting the heart are said to have congenital heart defects (CHD). To resolve these problems, surgery and catheter procedures are frequently necessary. The majority of CHD patients live into adulthood, and among the more than 2.4 million Americans with CHD, adults now outnumber children. However, a surgical procedure cannot treat CHD.

People may require many operations throughout their lives, as well as specialised cardiac care, particularly if they were born with significant heart conditions.

Adrienne H. Kovacs, Ph.D., chair of the writing committee for the scientific statement and a clinical psychologist who focuses on working with people who have CHD, said, “Decades of research describes the psychological and social stressors and challenges that can present across the lifespan for people with CHD.” “It’s past time that we go beyond awareness to action and give people with CHD better resources and specialised mental health care,”

A scientific statement from the American Heart Association is a professional evaluation of recent findings that could influence future recommendations. The Association addressed cognitive delays and other neurodevelopmental problems in children with CHD in a relevant scientific statement from 2011 on this subject.

To describe the psychological and social difficulties that people face from childhood through maturity and to discuss age-appropriate mental health interventions to enhance quality of life, this statement is the first of its kind.

The new claim states that compared to children without CHD, children with more complex CHDs have a 5-times increased lifetime risk of being diagnosed with anxiety. Only a small percentage of kids with CHD are given the option to receive mental health evaluations or treatments, despite the fact that these kids clearly have emotional, social, and behavioural issues.

Approximately 50% of adults with CHD will experience a mood or anxiety issue during their lifetime, compared to 30% of persons in the general population.

The following statement enumerates the psychological effects of CHD at different phases of life:

Early life — During surgery or other hospitalisation, babies may have traumatic or unpleasant treatments and may spend a lot of time away from their parents and other loved ones. As a result, newborns with CHD may suffer developmental delays, be hypersensitive to light and sound, have trouble eating and sleeping, or exhibit extreme fear and discomfort.

infancy — They might experience more hospitalizations and operations, which would limit their ability to play or go to school, and they might also experience developmental delays. In response, children with CHD could withdraw socially, show signs of worry or despair, struggle in school, or act aggressively or hyperactively.

Adolescence: As adolescents go from paediatric to adult care, they may have health issues at a time when they are trying to gain independence, growing their social circles, and taking on greater responsibility for managing their health care. Adolescents with CHD may experience social challenges, rage, defiance, or frustration in response, or they may struggle with body image issues. Additionally, they might engage in unsafe conduct or disregard health advice.

Getting older During adulthood, there could be repeated surgeries or other cardiac treatments, the development of new or worsening heart problems, and CHD could have a negative effect on possibilities for family planning, job, income, and insurance. Adults with CHD may thus struggle with interpersonal interactions, further education, or work.

They can also struggle with taking care of their own health requirements and develop worries about passing away.

“It makes perfect sense to experience a psychological reaction while dealing with a congenital cardiac abnormality. The illness poses a variety of difficulties throughout life and may involve unexpected news, such as recognising one can no longer physically handle the responsibilities of one’s profession or understanding that childbearing comes with considerable hazards “said Kovacs.

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“In the face of these difficulties, many persons with CHD demonstrate incredible resiliency. In order to help persons with CHD live a full and healthy life, we also wish to normalise psychological reactions and provide care for psychological wellbeing.”

The statement says that approaches to mental health care may include psychotherapy, such as talk therapies for individuals, couples, families, or groups; medication therapy, where a medical team can determine appropriate, heart-safe medications for depression or anxiety; and self-care strategies, such as relaxation techniques and hospital-based or online support groups.

The paragraph makes a solid case for the inclusion of mental health specialists in CHD specialty care teams. As soon as a health issue arises, improved timely access and coordinated care across the multidisciplinary health care team are all benefits of integrated mental health care. It also minimises stigma and normalises emotional responses to health difficulties.

The objective of this statement, according to Kovacs, is to promote psychologically informed care that empowers individuals with CHD and their families and offers emotional support. “Instead of being a specialised service that is only provided in some locations or under unique circumstances, we would rather that mental health assessment and assistance be a component of comprehensive treatment for all patients with CHD.”

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