Along with heart disease, the leading cause of death for both men and women in this country, cardiac arrest is also extremely common—and fatal in a vast majority of cases. Cardiac arrest occurs when the heart malfunctions and stops beating. (Contrary to a common misconception, cardiac arrest is different than a heart attack, which is when blood flow to the heart is blocked.)
Only roughly ten percent of people who experience cardiac arrest survive, the Sudden Cardiac Arrest Foundation states. What few know is that many of these survivors—one in three—will develop symptoms of post-traumatic stress disorder (PTSD), which in turn raises their risks of mortality.
Why PTSD After Cardiac Arrest Is So Common
Why the high prevalence of PTSD in the aftermath of cardiac arrest? A study by the National Institutes of Health pointed out that, thanks to developments in medical technology, an increasing number of people are living to remember their experience of cardiac arrest. Not surprisingly, it can be very traumatic, so that people may re-live aspects of it in various ways. They may recall symptoms like chest pain and shortness of breath, or they may have flashbacks of the defibrillator shocks or surgical procedures that brought them back.
Avoidance and arousal are other common features of PTSD. A person may avoid reminders of the event, such as the hospital that treated them. They might even avoid situations that could increase their heart rate. A case in point: exercise or sex.
Arousal often manifests as insomnia and hypervigilance. For instance, a person may be overly sensitized to physical sensations like chest pain or heart palpitations.
A New Intervention for PTSD from Cardiac Arrest
Until very recently, it was hard to know how to treat PTSD related to cardiac arrest. The big unknown had to do with the nature of the trauma, as Director of Columbia University’s PTSD Research and Treatment program, Yuval Neria, PhD, shared in a November 2023 release by Columbia University’s Department of Psychiatry. Trauma is often external to the person, Neria said, insofar as the event occurs outside of them. In the case of cardiac arrest, though, the trauma is internal and happens in the body.
This difference motivated Neria and her team to ask whether cardiac arrest survivors with PTSD could benefit from a new, more specialized intervention than exposure therapy alone. (Exposure therapy is one evidence-based treatment for PTSD, among others.) Would mindfulness in combination with exposure therapy prove more effective for this population than exposure therapy alone?
The answer that came back from a pilot study of the new intervention was a definitive “yes.” 80 percent of the test subjects experienced “significant improvement,” thanks to the new intervention, which consisted of exposure therapy and a mindfulness and acceptance component. Patients were encouraged to confront and process their traumatic memories through various techniques from exposure therapy. Meanwhile, they also learned mindfulness tools that helped them connect with and relate to internal body stimuli in healthier, more adaptive ways.
These findings are very encouraging, given the prevalence of PTSD in cardiac arrest survivors. They also help to illustrate the importance of specialized, integrated treatment that addresses both the mind and body (in this case, heart). In the end, prioritizing mental health is good for the heart, just as prioritizing cardiovascular health is good for the mind. There is never a better time to start than today.