Beyond the Heart: The Significance of Depression in Cardiac Surgery

OBJECTIVES: Preoperative depression is common among patients with cardiovascular disease and a significant risk factor for worse outcomes after cardiac surgery. This review summarizes the current evidence on depression as a risk factor and possible treatment options in patients undergoing cardiac surgery, and highlights future perspectives for clinical research. METHODS: This narrative review was based on a selection of key papers, identified through collegial expert discussions rather than a systematic literature search. RESULTS: Depression is often underdiagnosed and undertreated in patients undergoing cardiac surgery, significantly affecting recovery and increasing the risk of adverse outcomes. Implementing systematic psychological screening for depression and anxiety preoperatively and during follow-up is crucial for identifying at-risk patients. Psychological interventions, especially cognitive behavioral therapy have been shown to offer substantial benefits. Adopting a multidisciplinary approach integrating cardiovascular and psychological care is essential for improving recovery and long-term outcomes. Incorporating psychological screening and interventions into standard care can enhance postoperative outcomes, reduce complications, and provide comprehensive support for cardiac surgery patients. CONCLUSIONS: Depression is often overlooked in cardiac surgery patients, despite its significant impact on recovery and long-term outcomes. Systematic psychological screening before and after surgery together with a multidisciplinary approach integrating cardiovascular and psychological care can improve patient outcomes. Future research should clarify how depression and cardiovascular disease are linked, assess treatment effectiveness, and identify appropriate intervention strategies.