The Impact of Fear of Recurrence and Progression on Mental Health after Spontaneous Coronary Artery Dissection: The Role of Illness Uncertainty

Abstract Aims Spontaneous coronary artery dissection (SCAD) is a cause of acute myocardial infarction that is marked by a particularly challenging psychosocial recovery period. Survivors commonly experience fear of recurrent events and uncertainty around their condition. These psychosocial challenges may contribute to anxiety, depression, and cardiac distress. This study investigated the relationship between fear of recurrence and progression (FoRP), uncertainty, and psychological outcomes, specifically whether illness uncertainty moderates the relationship between FoRP and mental health outcomes in SCAD survivors. Methods and results Participants were recruited from the Victor Chang Cardiac Research Institute Arteriopathy and SCAD Cohort (VASC). Two hundred and seventy survivors completed an online questionnaire measuring FoRP, illness uncertainty, anxiety, depression, and cardiac distress. Moderation analyses were undertaken to investigate the relationship between these variables. FoRP directly predicted all three mental health variables. Illness uncertainty moderated this relationship in the case of depression and cardiac distress. Conclusion The findings indicate specific intervention targets to meet the support needs of survivors. While fear of recurrent events is common following SCAD, managing illness uncertainty may be a means to reduce the impacts of this fear on survivor’s mental health.