Mental Health Sequelae of Cardiac Events: A Comprehensive Review of Biological Mechanisms, Prevalence, and Interdisciplinary Care Approaches

Cardiovascular diseases are the leading cause of mortality worldwide, with postcardiac events such as myocardial infarction, acute coronary syndrome, and sudden cardiac arrest causing significant physiological trauma and psychological effects. This study explores the complex interplay between cardiac events and mental health disorders, focusing on the biological and psychological pathways that connect these conditions in at-risk populations. The acute stress response following a cardiac event involves the activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to the release of stress hormones and inflammatory cytokines. Prolonged activation of these systems can result in neurotransmitter imbalances, neuroinflammation, and epigenetic modifications, increasing the susceptibility to mental health disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). Women exhibit a higher vulnerability to these conditions due to hormonal fluctuations and a more pronounced stress response. The prevalence of mental health disorders following cardiac events is substantial, with PTSD rates being particularly high among survivors of myocardial infarction and out-of-hospital cardiac arrest. These psychological conditions are associated with poor physical recovery, reduced quality of life, and an increased risk of recurrent cardiac events and mortality. Resilience and adaptive coping mechanisms serve as protective factors, highlighting the importance of integrating mental health care within cardiac rehabilitation programs. This study emphasizes the need for early detection, targeted interventions, and an interdisciplinary approach to improve mental health outcomes in patients recovering from cardiac incidents. Understanding the psychiatric sequelae of cardiac events is crucial for cardiologists, particularly in the management of postmyocardial infarction patients, ischemic attack survivors, and individuals undergoing open-heart surgery. Early detection and interdisciplinary interventions can improve long-term outcomes.