Cardiac PTSD: New Strategies Emerge to Aid Recovery

Innovative approaches aim to mitigate trauma after life-altering cardiac events.

For those who survive major heart incidents, the ordeal doesn’t always end with physical recovery; many grapple with cardiac post-traumatic stress disorder (PTSD). Researchers are now developing new interventions to help patients avoid or escape this cycle.

Understanding Cardiac PTSD

For almost fifteen years, Donald Edmondson, PhD, at Columbia University Irving Medical Center, has focused on cardiac PTSD. His work highlights that a significant portion—up to one-third—of individuals develop this condition after major cardiac events.

James Jackson, PsyD, at Vanderbilt University, was among the first to specifically address cardiac PTSD. He noted the scarcity of support programs for cardiovascular ICU survivors, unlike those available for cancer survivors.

“We tailor our care and try to individualize it, but there is always a strong psychological component, with a particular focus on mental health and neuropsychological challenges,” said Jackson. He emphasizes the importance of early intervention to prevent these issues from becoming more difficult to manage.

Simple Screening System

According to Edmondson, interventions could begin with a straightforward four-point screening system integrated into routine cardiology follow-ups. This would involve identifying patients who were significantly frightened by their cardiac event.

Additional indicators include patients who frequently discuss their cardiac sensations, report sleep disturbances, or have reduced physical activity. These factors can collectively signal a higher risk of developing cardiac PTSD, according to research findings.

If a patient is deemed high risk, Edmondson suggests referral to a behavioral health professional. Exposure therapy may be considered, alongside other therapeutic approaches, depending on the patient’s specific symptoms.

Edmondson also noted that the existing depression care model in cardiology could be expanded. Preliminary data suggests bringing behavioral health into cardiology clinics could reduce cardiac risk and improve health behaviors for recent cardiac event survivors.

The Role of Compassion and Tech

A 2019 study by Jeena Moss, MD, found that clinician compassion and a less stressful medical experience can disrupt the cycle of cardiac PTSD. However, standardizing these elements remains a challenge.

Interestingly, a 2018 study co-authored by Edmondson revealed a placebo-like effect from percutaneous coronary intervention (PCI) and stent placement. He believes some patients incorrectly feel “cured” by these procedures, embracing a “plumbing’ model of ACS.”

Tech-Driven Interventions

Jeffrey L. Birk, PhD, MS, at Columbia University, is exploring technology-based interventions to address patients’ fears of recurrent cardiac events. His work focuses on internal triggers like increased heart rate and perceived arrhythmias that can be misinterpreted as dangerous.

Birk aims to develop systems that can dynamically assess these processes in real-time, understanding when and how interoceptive attention affects patients’ well-being.

Similarly, Sachin Agarwal, MD, MPH, is investigating how AI-powered models can offer personalized support, improve follow-up, and broaden family-centered interventions. According to the CDC, about 1 in 5 heart attack survivors experience depression, highlighting the need for comprehensive mental health support.

“We’re beginning to explore how AI-powered survivorship models can deliver personalized support, improve follow-up engagement, and extend the reach of family-centered interventions beyond the hospital walls,” said Agarwal. He envisions these tools as sustainable, system-wide solutions.