STUDY OF CLINICAL PROFILES OF DEPRESSION, ANXIETY AMONG FEMALE POST MYOCARDIAL INFARCTION PATIENTS

Dr. M. Seenivasan MD, Dr. D. Sivalingam MD* and Dr. L. Sriram MD

ABSTRACT

It is well known that there is a close relationship between cardiac function and psychological factors. All human beings have emotions like anger, sad, fear, joy which have direct effect on cardiac function.[1] Variations in heart rate and rhythm occurs in relation to these emotions. Myocardial infarction, commonly known as heart attack is irreversible necrosis of heart muscle cells due to prolonged ischemia. Most heart attacks are caused by obstruction to blood flow in the coronary vessels by atherosclerotic plaques, made up of cholesterol and other cells. The pathogenesis of myocardial infarction can include (i) occlusive thrombus – thrombus overlying plaque causes seventy five percent (75%) of myocardial infarction with superficial plaque erosion in 25%. (ii) Vasospasm – with or without atherosclerosis of coronary arteries and association with platelet aggregation (iii) Emboli – from other sites. WHO[1] report says that in 2004, 12.2% of worldwide deaths were due to ischemic heart disease. In most high income countries, there was declining trend of death from ischemic heart disease. In contrast to developing countries like India, death due to ischemic heart disease was expected to increase double during 1985-2014.[2] WHO 2008 report also predicted that DALYS (Disability Adjusted Life Years) lost to coronary artery disease will be 5.5% of total DALYS in 2030; after major depressive disorder, it is the second most important cause of disability. The disease can indirectly affect mental function, producing chronic impairment, most commonly associated with depression and anxiety. So recently much attention was given to psychological and social factors in relation to myocardial infarction (coronary artery disease). The factors that lead to development of atherosclerosis in blood vessels are diabetes mellitus, dyslipidemia and smoking which are associated with psychosocial factors also. Genetic factors also play important role in atherosclerosis development.

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