After a heart attack, it’s natural for survivors to feel stress, and new research shows that fear of having another heart attack may play a big role in that stress.
Understanding this fear and how it differs from conditions like anxiety and depression could lead to better care for heart attack survivors, says Dr. Sarah Zvonar, a cardiac critical care nurse and researcher at Indiana University.
Dr. Zvonar presented her findings at a recent conference of the American Heart Association. Although the results are still considered preliminary, they shed light on how fear of recurrence—the worry that another heart attack might happen—affects survivors’ stress levels.
What Is Fear of Recurrence?
Fear of recurrence has been studied more often in cancer patients, but it hasn’t received as much attention in heart health. Dr. Zvonar was inspired to explore the topic after seeing her father and the fathers of several friends cope with heart attacks.
Their frequent question—”Will this happen again?”—sparked her interest in understanding the emotional challenges heart attack survivors face.
To study this fear, Dr. Zvonar and her team surveyed 171 heart attack survivors who had experienced their first heart attack within the past six months.
Participants answered questions about their stress levels, anxiety, depression, fear of recurrence, and how they viewed their overall health. Six weeks later, the surveys were repeated.
Key Findings
The study revealed that certain groups were more likely to experience fear of recurrence. Younger people and white participants were more affected by this fear compared to older individuals or Black participants.
Additionally, people’s perceptions of their health—how long they believed their condition would last or how much control they felt they had over it—strongly influenced their fear of recurrence.
Stress levels were found to be connected to fear of recurrence as well as alcohol use. Even when researchers accounted for anxiety and depression, fear of recurrence remained a key factor contributing to stress.
Dr. Zvonar explained that survivors who experienced more fear of recurrence were also more likely to have higher stress levels, which could increase their risk of future heart problems, including another heart attack.
How Fear of Recurrence Differs from Anxiety and Depression
While anxiety and depression are long-term mental health conditions that often require medication, fear of recurrence is different. It can be more situational, popping up suddenly.
For example, survivors might feel scared when they experience minor chest pain, wondering if it signals another heart attack. Or they might avoid seeing a doctor because they fear bad news.
Dr. Kim Feingold, a cardiac psychologist, says that fear is a natural response to a perceived threat, but chronic fear can harm a person’s mood and health.
Many survivors lose confidence in their bodies after a heart attack and struggle to understand whether new symptoms are serious or not. This uncertainty adds to their stress and fear.
Dr. Feingold compared the experience to being in a car crash and then having to drive again. While it’s scary at first, most people gradually feel more comfortable over time.
Helping Survivors Cope
Early support from healthcare professionals can make a big difference. For example, doctors can help survivors interpret symptoms and decide when it’s appropriate to seek medical attention. This reassurance can reduce fear and build confidence over time.
Dr. Zvonar emphasized that more research is needed to develop ways to help survivors manage their fear and stress. Her study had limitations—it included mostly younger women (average age 39), whereas most heart attack survivors in the U.S. are older.
Additionally, the six-week timeframe for the surveys was relatively short, and fear of recurrence did not significantly decrease during that period.
Future research could focus on how to help both survivors and their families navigate these emotional challenges. “We need to do more to support survivors, not just to help them live longer but to ensure they have a better quality of life,” Dr. Zvonar said.
This work highlights the importance of addressing not only the physical recovery after a heart attack but also the emotional well-being of survivors. By understanding and tackling fears like recurrence, healthcare providers can help survivors regain confidence and improve their overall health.
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