Post-SCAD Mental Health

Depression and anxiety after heart attacks (myocardial infarctions) are common and associated with increased rates of illness and death. However, heart attacks caused by arterial plaques differ dramatically from heart attacks caused by SCAD in terms of which populations are affected, the resources available to them, and their functional changes and outcomes.

Associations between SCAD and depression, anxiety and post-traumatic stress disorder (PTSD) are unknown; this project aims to determine the prevalence and predictors of depression, anxiety and PTSD in people who have survived an occurrence of SCAD.

In this cross-sectional study, the SCAD Research Program team surveyed people who have survived SCAD to screen for depression and anxiety. Symptoms of mental and physical health are included in the surveys, as are environmental, socioeconomic and clinical cardiovascular characteristics.

Overall, mean survey scores suggest borderline mild depression, anxiety or both — and in some people, PTSD. Younger age appears to be associated with higher scores, as does occurrence of SCAD in the period before or after giving birth. Participants who were treated with percutaneous coronary intervention have lower scores.

The research team's initial conclusion is that symptoms of depression and anxiety are common in patients who have heart attacks due to SCAD, particularly younger women and those with peripartum SCAD. Assessments may detect anxiety, depression and even PTSD in SCAD survivors who do not self-report these disorders, suggesting a role for routine screening in these patients. Mayo Clinic's SCAD research team is investigating possible interventions.