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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-eight children, aged 1-4 years, with a query or definite diagnosis of congenital heart disease (CHD) were observed during an X-ray procedure and their behaviour rated on an amended version of the Observational Scale of Behavioural Distress. Families were followed up and assessed on a number of psychosocial variables. High rates of behavioural distress were found to be associated with children's low stranger sociability and parental style of discipline. Possible patterns of interaction between CHD children and their families are discussed.
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PMID:Short communication: the importance of psychosocial factors in understanding child distress during routine X-ray procedures. 224 45

Anxiety and depression for 399 survivors of a 1,102-member heart disease cohort were assessed 8 to 9 years post-hospitalization. Approximately one-third reported symptoms of emotional distress and one-fourth were on anti-anxiety drugs. Predictors of anxiety and depression were analyzed through logistic regression. Subjects age 65 and over were less likely than younger patients to report anxiety or depression and also reported less heart-associated disability, the strongest predictor of distress for both age groups. Other significant predictors included a previous history of distress, low income, female sex, and beta blocker use.
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PMID:Depression and anxiety among chronically ill heart patients: age differences in risk and predictors. 232 Jul 61

Short-term and long-term use of physician consultations and rehospitalizations were studied in 383 myocardial infarction (MI) patients in relation to demographic, medical, and psychological factors. Short-term (i.e. within 6 months post-MI) utilization of physicians was only related to patients' health locus of control. In comparison, a higher number of physician consultations 3-5 years after the MI was independently related to female sex, more non-cardiac limitations before the MI, more complications during hospitalization, less cardiac lifestyle knowledge, and higher levels of anxiety and depression short time after the MI. Every second patient was readmitted to the hospital before the 3-5 years follow-up but only 14% suffered a non-fatal reinfarction. More rehospitalizations were independently related to a higher number of previous hospitalizations for heart disease, more pre-MI cardiac limitations, less cardiac lifestyle knowledge, and higher initial level of emotional distress. Discriminant analysis identified female sex and patients' initial expectations of reduced emotional control as the best predictor variables for a rehospitalization caused by chest pain without a new infarction, whereas a reinfarction was best discriminated by the number of previous hospitalizations for heart disease. We conclude that psychological factors influence health services utilization to a comparable extent as medical factors. These findings may indicate a greater need for long-term professional support in patients with less initial cognitive and emotional control.
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PMID:Use of health services after a myocardial infarction. 271 Nov 51

Psychosocial adjustment to heart disease is variable. Some patients recover from a myocardial infarction or cardiac surgery quickly, return to work and leisure activities, and experience little emotional distress. Others suffer significant problems in psychosocial adaptation. We proposed and tested a theoretical model of adjustment that included the quality of the marital relationship, dysphoria, chronologic age, and time from the cardiac event (myocardial infarction or surgery) to identify the role that these variables play in adjustment. The study was conducted in 198 men diagnosed with coronary heart disease using the following instruments: the Spanier Dyadic Adjustment Scale, the Multiple Affect Adjective Checklist, and the Psychosocial Adjustment to Illness Scale. Data were collected on entry into the study and 3 months later to identify the stability of the relationships over time. The theoretical model was supported. Findings demonstrated that positive psychosocial adjustment to illness is influenced both by the quality of the patient's marriage and dysphoria. The spouse appears to influence psychosocial adjustment in an indirect manner by influencing the patient's experience of emotional distress or dysphoria. Nurses can enhance psychosocial adjustment to coronary heart disease by helping patients and spouses focus on ways to improve the quality of their marriage and by suggesting strategies to improve marital communication and decrease fear and misconceptions related to the illness.
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PMID:The relationship of marital quality and psychosocial adjustment to heart disease. 799 71

Women comprise only a small percentage of subjects in studies of psychosocial responses to heart disease. Some research suggests women have higher rates of anxiety and depression post myocardial infarction than men. This descriptive-correlational study examined role enactment and emotional responses of nineteen women with ischemic heart disease four to six weeks after discharge from hospital. More specifically, the study examined the relationship among Physical Symptoms, Quality of Role Enactment, and Emotional Response. Study findings suggest subjects were generally satisfied with their role enactment. There were no relationships among the three study variables-Physical Symptoms, Quality of Role Enactment, and Emotional Response. However, women who experienced a myocardial infarction and those with other forms of ischemic heart disease differed in terms of physical symptoms and role enactment after discharge. Subjects did not report high levels of depression; yet, there was some indication of emotional distress. Interestingly, the first two weeks after discharge were described as the most difficult time. The results from this study point to areas of further research.
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PMID:Role patterns and emotional responses of women with ischemic heart disease 4 to 6 weeks after discharge from hospital. 814 69

The U.S. District Court, District of South Carolina, held that the parents of a child with Down's syndrome were entitled to recover damages for the medical and custodial expenses necessitated by the child's condition due to the failure of the Naval Regional Medical Center staff to provide adequate genetic counseling and prenatal testing. Members of the staff also failed to diagnose and treat a cardiac disorder in the newborn child. Additional damages awarded to the parents for emotional distress were reduced by half to account for the benefits of the child's birth, despite his condition.
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PMID:Phillips v. United States. 1164 35

Psychosocial aspects of heart diseases have usually been studied in predominantly male patients. Growing evidence shows that the results of these studies cannot simply be generalized to women. The research on associations between psychosocial factors and heart disease, especially coronary heart disease, in women is therefore summarized in a literature review. The literature shows that women are subject to adverse cardiac effects of stress and chronic negative affects in a similar way as men. However, in women the relevant sources of distress are often found in other areas, i.e., in the family and household environment, and less often at the workplace. Especially for working mothers, the combination of professional and household work constitutes a considerable stressor.Stress is also perceived differently in men and women, and it leads to different physiological reactions. One striking example is the recently described "stress cardiomyopathy", an acute, life-threatening illness, which is often triggered by sudden emotional distress and can mainly be found in women. Women with heart disease report more psychological distress in response to their illness than men. As in men, depressive symptoms may negatively impact prognosis. Nevertheless, women receive less rehabilitation treatment than men and also benefit less from common psychological offerings. There is some evidence that women need specially developed psychosocial interventions and should not simply be treated in predominantly male stress-management groups. In clinical practice, gender-specific stressors and accompanying psychological symptoms should be discussed with the female heart patient. If needed, she should receive individualized psychosomatic treatment.
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PMID:[Stress and heart disease in women]. 1613 45

Catecholaminergic polymorphic ventricular tachycardia is a rare entity that can occur in children without cardiac disease and with a normal QT interval. It may cause syncope, convulsions, and sudden death during physical activity or emotional distress. We report the clinical features, treatment, and follow-up of 16 children with this diagnosis, emphasizing the potentially fatal nature of the disease.The mean age of patients at the onset of symptoms and at the time of diagnosis was 7.8 plus or minus 2.5 years, and 10.6 plus or minus 3.5 years, respectively. Syncope was the main complaint in 11, and 7 were treated as erroneously as having epilepsy. Diagnosis was confirmed by exercise and/or infusion of isoproterenol. Once the diagnosis was made, we started propranolol in all patients, and added verapamil if ventricular tachycardia was still inducible on a treadmill exercise test. An intracardiac defibrillator was implanted in 4 patients. Of the 16 patients, 4 died suddenly, giving a rate of mortality of 25%. In 2 of those dying suddenly, there was evidence of poor compliance to the recommended treatment. Another 2 patients had been resuscitated because of sudden cardiac arrest.Catecholaminergic polymorphic ventricular tachycardia must be considered in the differential diagnosis of syncope in children without heart disease but with a normal QT interval. Medical treatment with propranolol and verapamil may decrease the incidence of arrhythmia. Implantation of intracardiac defibrillators should be considered in those resistant to drug therapy. Delay in diagnosis, and inadequate treatment, can result in sudden cardiac death.
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PMID:Clinical experiences of patients with catecholaminergic polymorphic ventricular tachycardia. 1910 2

In the current study, the prevalence of the most common psychological disorders in COPD patients and their spouses was assessed cross-sectionally. The influence of COPD patients' and their spouses' psychopathology on patient health-related quality of life was also examined. The following measurements were employed: Forced expiratory volume in 1 second expressed in percentage predicted (FEV1%), Shuttle-Walking-Test (SWT), International Diagnostic Checklists for ICD-10 (IDCL), questionnaires on generic and disease-specific health-related quality of life (St. George's Respiratory Questionnaire (SGRQ), European Quality of Life Questionnaire (EuroQol), a modified version of a Disability-Index (CDI)), and a screening questionnaire for a broad range of psychological problems and symptoms of psychopathology (Symptom-Checklist-90-R (SCL-90-R)). One hundred and forty-three stable COPD outpatients with a severity grade between 2 and 4 (according to the GOLD criteria) as well as 105 spouses took part in the study. The prevalence of anxiety and depression diagnoses was increased both in COPD patients and their spouses. In contrast, substance-related disorders were explicitly more frequent in COPD patients. Multiple linear regression analyses indicated that depression (SCL-90-R), walking distance (SWT), somatization (SCL-90-R), male gender, FEV1%, and heart disease were independent predictors of COPD patients' health-related quality of life. After including anxiousness of the spouses in the regression, medical variables (FEV1% and heart disease) no longer explained disability, thus highlighting the relevance of spouses' well-being. The results underline the importance of depression and anxiousness for health-related quality of life in COPD patients and their spouses. Of special interest is the fact that the relation between emotional distress and quality of life is interactive within a couple.
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PMID:Mental disorders and quality of life in COPD patients and their spouses. 1928 Oct 87

The Minnesota Muliphasic Personality Inventory (MMPI-2) is widely used in chronic illness and chronic pain populations to assess psychological functioning. We report the results of the first investigation using the MMPI-2 to assess psychological aspects of patients with Fabry disease. Fabry disease, an X-linked lysosomal storage disorder, is a multisystem progressive disease affecting the kidney, heart, and central nervous system, and is particularly associated with chronic symptoms including pain. In this study, 28 patients with Fabry disease completed the MMPI-2 and a background questionnaire. Fabry disease patients scored significantly higher than the MMPI-2 normative sample on seven clinical scales (Hs, D, Hy, Pd, Pa, Pt, Sc) and two validity scales (L, F). Individuals with elevated scores on the Hs, D, and Hy scales tend to have somatic complaints, sadness, and emotional distress. Under stress, they may experience an increase in physical symptoms. Elevated Pd, Pa, Pt, and Sc scales suggest social maladjustment, suspiciousness, and feelings of isolation. An elevated L scale suggests defensiveness; a high score on F suggests emotional turmoil. When compared with cohorts of patients with Gaucher disease (GD), chronic heart disease (CRHD), and chronic pain, the Fabry disease patients had significantly higher scores than GD patients and CRHD patients on numerous clinical (Hs, D, Si), and validity (F) scales underscoring the relative amount of suffering and pain experienced by Fabry disease patients. No significant differences on any MMPI-2 scales were found between the Fabry disease patients and the pain patients, suggesting that Fabry disease patients may be comparable to pain patient populations.
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PMID:Psychological aspects of patients with Fabry disease. 1992 64


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