Are Acute Myocardial Infarction Patients at risk of Post-Traumatic Stress Disorder - Essay Example

Acute Myocardial Infaction The methods used in the research included studying participants and their recruitment, clinical investigation and statistical analysis.The study had 40 participants, 78% were men, and they had an average age of 54 years. The participants had been diagnosed with PSTD using the clinically administered PSTD scale. After approximately 6-15 months after experiencing a myocardial infarction the first entry was done and a follow up was done after another 12 months.24 patients underwent the second diagnostic test and two thirds of them still qualified for diagnostic follow up. Generally, PSTD symptoms such as re-experience symptoms, avoidance, and hyper- arousal had decreased. However, the 16 patients who qualified for a follow up still showed symptoms of hyper arousal and avoidance. The fact that three thirds still qualified for a follow-up showed that in post MI patients, clinical PSTD is a persistent condition. Background Information Acute myocardial refers to a conditionnormally known as a heart attack. Acute refers to a sudden and seriousattack. It is usually becauseof an injury on the cardiac muscles. Just like any muscle, the heart requires continuous nourishment of nutrients and oxygen (Tcheng, 2009). Two coronary arteriesare responsible for supplying blood to the heart, when one of the coronary artery faces blockage,there is no blood flow, and the heart gets oxygen starved, a condition known ascardiacischemia (Aziz & Abele, 2009). If this condition lasts longer, the heart muscle dies hence occurrence of a heart attack.The blockage can be due to accumulation of fats as well as white blood cells. It is necessary to take precaution and early medical help in case of symptoms. The warning symptoms may include an irregular heartbeat or a slow pulse rate, fatigue, dizziness, loss of breath and even loss of consciousness. It however unfortunate that some people do not experience ant of these symptoms and their situation is referred to as silent ischemia. Women may nor experiencechest pains but may have pain in the abdomen and the back. Constantandfrequent angina is awarning sign of a heart attack (Jevon, 2012). There are various ways of diagnosing heart attacks and they include the electrocardiogram, blood test, cardiac catheterization, and echocardiogram (Field, 2009). Modes of treatment include using clot bursting drugs, balloon angioplasty, stent placement, and bypass surgery. A quarter of heart attack victims die before reaching the hospital. Other face serious complications while in hospital such as stroke, bulging of the weakened hart chamber besides blockage of arteries in the legs. Those who survive the initial attacks stand a chance of recovery. Recovery is delicate process because the heart muscle is injured. Many of the survivors of heart attack tend to go through post-traumatic stress disorder (England, 2010). Study participants and recruitment Recruitment involved finding 40 participants who been clinically diagnosed with PSTD. The sample includespeople who had developed PSTD following a MI. After a period of oneyear, the sample were asked to volunteer in a follow up to access PSTD and 24 of them accepted to be part of the follow up. CAPS process is usually used to analyse current and lifetime PSTD. According to the CAPS system, the seventeen symptoms of PSTD are used to rate, the patients using a 5point scale that ranges from zero which indicates never to 4 which indicates always. Thesymptoms scale provides continuous measure of PSTD symptoms development. Data was analysed using astatistical software package and was provided in original units. Results The patients were analysed using demographic, psychometric and medical parameters. 16 patients were not there for the follow up but 24 werethere. Four patients admitted to having use anti-depressants medications. Follow up also showed that there were no cases of cardio vascular ailments that may have led to hospital admissions. Somethree patients also admitted to have undergone coronary stenting during 4, 14 and 32 month aftermyocardialinfection. In the first test, 14 patients had full PSTD and 26 had sub threshold PSTD.In the next follow up, 24 patients were analysed and 11 of them had full PSTD whereas 13 has sub thresholds PSTD. In eightpatients,therewas an evident decrease in the avoidance symptoms,re-occurrencesymptom and hyper arousal symptoms when entry and follow up data was compared. Among the 24, 8 did not qualify for the criteria of diagnostic PSTD. However, 16 of them showed no decrease avoidance symptoms as well as hyperactive arousal symptoms hence they maintained a diagnostic of PSTD Discussion There was a 33% decrease in patientsshowing diagnostic PSTD and that was important to note. Two thirds of the patients however still showed interviewer- related diagnostic PSTD two year after the firstentry. It was evident from the study that the symptom of avoidance and hyperactive arousal are the ones that caused the two thirds of the patients to remain under diagnostic PSTD. The study also showed that duration of follow up allowed decreased level of the clusters of PSTD. PSTD gotten from MI is more complex compared to other forms of trauma because the heart is part of the body and the patients remember the trauma with very heartbeat that passes. Thisunavoidable and constant confrontation with the heart may make PSTD develop more with time and they avoidance symptoms do not change. Hyperarousal among MI patients is also stimulated by the anger, anxiety as well as the depression inpatients. Even as PSTD related hyperactivearousalslike insomnia decrease, other factors that are non-PSTD may stillcontribute to hyperactive arousal among theparients (Foa, 2009). The findings of the study shows that the PSTD is common among MI paints and the results are clinically useful. This study method was effective because it involved use of standard psychiatric interview to explain PSTD compared to other studies, which use questionnaires. The study also has its weaknesses because it used a small sample for the findings. Because the sample was small, there was no diversity in the results. Follow up was not done well because some patients did not show up. Women are more prone to PSTD compared to men and children are less susceptible.After experiencing a heart attack, patients develop a sense of fear and helplessness,theyare afraid that they may lose their lives, in case it re occurs.This sense of fear and loss of control contributes to PTSD in 15% of the patients. To reduce the instances of this disorder, a study for prevention was conducted. It is called the Myocardial infarction stress prevention intervention (MI-SPRINT).Its main objective is to use trauma forced counselling which is more effective than non-trauma forced counselling in preventing instances of PSTD after a myocardial infarction. PSTD is accompanied by three common symptoms such experiencing the traumatic events in thoughts and dreams, avoiding anything that may remind one about the traumatic event as well as hyperarousal.These symptoms may last for months and they may impair daily lives. Cardiac patients have limited access to psychological care early enough. The prevention programme MI-SPRINT should intervene in such cases and offer psychological support to patients who show sighs of developing PTSD. The study will help patients live a quality life without depression and it may improve cardiovascular prognosis as well (Esselstyn, 2007). The method also comes with extremevalidityand their biomedical output is well established. This method however has some limitation to its cause. Only those who are willing to take part in the screening will feel the questions. However, some over distressed patients who were severely affected by the heart attack may escape going through this screening. They are the ones who end up developing Posttraumaticstress disorder. References Tcheng, J. E. (2009). Primary angioplasty in acute myocardial infarction.New York: Springer. Jevon, P. (2012). Angina and heart attack. Oxford: Oxford University Press. Esselstyn, C. B. (2007). Prevent and reverse heart disease: The revolutionary, scientifically proven, nutrition-based cure. New York: Avery. Foa, E. B., & International Society for Traumatic Stress Studies. (2009). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press. Aziz, K. S., &Abela, G. S. (2009).Diagnostic imaging of coronary artery disease.Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. England, D. (2010). The Post Traumatic Stress Disorder Relationship: How to Support Your Partner and Keep Your Relationship Healthy.Cincinnati: F+W Media. Field, J. M., American College of Emergency Physicians.,& American Heart Association. (2009). The textbook of emergency cardiovascular care and CPR. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Read More