Key result
Psychiatric factors and stress play a significant role in coronary heart disease, requiring careful selection of antidepressants due to potential cardiotoxicity.
Highlights the importance of considering psychogenic factors, stress profiling, and the careful selection of psychotropic medications to avoid cardiotoxicity in patients with cardiac disorders.
Psychiatric factors merit consideration in CHD care; leaves open optimal antidepressant selection pending higher-level evidence.
A number of the aetiological factors associated with coronary heart disease (CHD) have psychogenic components, ie alcohol consumption, smoking, obesity, sex, sleep and heredity. Placebo‐controlled trials of anxiolytics in CHD and hypertension have yielded conflicting results. For the cardiac patient suffering from depression, the choice of an antidepressant drug is important in view of the potential cardiotoxicity of the tricyclic compounds. Stresses that produce anxiety in cardiac patients and others may be multiple and varied in nature. At the Stress Clinic at the Maudsley Hospital in London, stratified questionnaires are used to assess a number of different stress factors and the severities of these can then be compared by constructing a stress profile for each patient.
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David Wheatley (1987) conducted a review in Coronary heart disease and cardiac disorders. Psychiatric assessment and psychotropic medications was evaluated. Psychiatric factors and stress play a significant role in coronary heart disease, requiring careful selection of antidepressants due to potential cardiotoxicity.
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