In a highly regarded U.S. cardiology journal, doctors in Europe emphasize how the mind and body work together for more total healing.
If you or a loved one have experienced a heart attack, you know it’s one of the most frightening events in an individual’s life. What’s less discussed in our culture is that for many survivors, the fear doesn’t end when they’re discharged to go home.
A significant number of heart attack patients recover physically, but develop what some researchers call “cardiac anxiety”: a persistent, often debilitating fear of another cardiac emergency that leads them to avoid physical activity, obsess over their health, and pull back from the life they were living before.
Despite how common it is, cardiac anxiety rarely gets addressed in standard follow-up care. A new study published in the Journal of the American College of Cardiology, which is one of the most prestigious cardiovascular journals in the world, suggests it should be.
Twelve cardiology, psychology, and neuroscience researchers at Karolinska University Hospital in Stockholm, Sweden conducted a randomized clinical trial, the gold standard in medical research. Heart attack survivors with significant cardiac anxiety were assigned to either eight weeks of therapist-guided cognitive behavioral therapy (CBT) via telemedicine visits, or standard heart attack recovery care alone.
The National Library of Medicine explains that CBT is an evidence-based form of talk therapy. “[…T]he basic idea behind the therapy is always the same: What we think, how we behave, and how other people make us feel are all closely related – and they all affect our wellbeing.” Possible explorations they list: “Do you see things realistically? What happens if you behave differently than you normally do in a certain situation? In the therapy sessions, you will regularly discuss any problems you may have and progress that you have made.”
The results of the Karolinska University study were eye-opening. Compared to patients who received standard care, those who completed the digital CBT program reported concrete improvements in their day-to-day functioning. Specifically, they were better able to engage in physical activity—which is often recommended as part of cardiac recovery and future prevention. They also experienced fewer limitations in their daily lives, and reported a meaningfully higher quality of life. Cardiac anxiety also reduced significantly.
Even after talk therapy, those gains didn’t fade. When researchers followed up at 12 months, the improvements had held.
The findings make a strong case for something Western medicine has been slow to prioritize: treating the psychological aftermath of a heart attack has clinical importance, just as managing cholesterol or blood pressure do.
The telemedicine format matters, too. This kind of support could reach patients in areas with limited access to mental health care, including where population health trends show higher heart attack rates.
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