A palpable depression

Several studies have shown that patients with depression, anxiety and stress have a higher ratio in developing atrial fibrillation (AF), with higher proportion occurring in patients with recurrent episodes of AF which are related to severity of disease and increased mortality ratio. We aim to discuss the case of AF caused by mental disorder to examine its relationship and impact in patient’s clinical outcomes. A 70 years-old-man came to clinic with palpitation five days before admission. He often cries and has not been able to sleep since his wife died three months prior. He admits to have neither hope nor desire to do his usual activities or even start new activities. Vital signs show BP 140/90 mmHg, pulse 150x/m, RR 20x/m, SpO2 98%. Cardiopulmonary examination revealed irregular S1-S2. ECG shows premature atrial contraction which evolved to asinus rhythm with HR 150x/minute, AF and incomplete right bundle branch block a months after the first ECG was examined. Depression-Anxiety-stress scoring-42 (DASS-42) was conducted in this patient. Results shows the patient has very severe depression, intermediate anxiety and severe stress. Mental disorders lead to increased etiology of cardiac remodeling factors due to degeneration and sympathetic stimulation, which then induced the AF. Further research is needed to examine whether psychiatric treatment can prevent AF in improving quality of life, healthy behavior and awareness for managing mental health.