Can my patient really have PTSD after a Heart Attack?

Heart attack or myocardial infarction is a health problem that many of us are aware of and often we know some one who has survived the event. It might be hard to believe that a heart attack and PTSD could be associated. However, the research as discussed below shows that there can be a link.

Jacquet-Smailovic and colleagues (2021) conducted a systematic review of 39 articles examining Posttraumatic Stress Disorder following myocardial infarction. They reported that the results of the studies in their review suggest that the occurrence of an acute cardiac event is likely to contribute to the development of PTSD.

They highlighted that PTSD after myocardial infarction is also a predictor of an increased risk of recurrent adverse cardiovascular events and mortality. Previous research reported on this blog, has stated that the link between PTSD and cardiac events is not direct. However, it seems in specific circumstance of myocardial infarction there is a reverse association for some.

Pre-existing Factors

Jacquet-Smailovic and colleagues (2021) outlined interesting results from several of the studies in their review including:

  • That younger people are at higher risk of developing PTSD compared with older individuals and men.
  • There was no research evidence to support a positive effect of socioeconomic status on an individual’s risk of developing PTSD (socioeconomic status is a risk factor for myocardial Infarction).
  • Experiencing mental disorders, such as depression and PTSD, and/or substance abuse before the onset of a cardiac event could predict the severity of myocardial Infarction induced post-traumatic stress symptoms.
  • Exposure to negative or potentially traumatic life events before myocardial Infarction was:
    1) Positively correlated with the severity of post trauma symptoms.
    2) Shown to significantly lower remission rates of myocardial Infarction induced PTSD in the 8 years following the cardiac event.


Findings also showed associations between PTSD secondary to myocardial Infarction. Personality traits, such as anxious attachment or alexithymia, were associated with PTSD development. In contrast, personality traits such as resilience, characterized by a sense of personal competence and acceptance of self and existence, were shown to be a protective factor for PTSD after myocardial Infarction.


There are a number of factors to consider if a client presents with possible PTSD after a heart attack, including prior trauma, age and pre-existing other mental health difficulties. All of which are indicative of the application of a trauma focussed therapy such as CPT in order to reduce their potential for further morbidity.


Jacquet-Smailovic, M., Tarquinio, C., Alla, F., Denis, I., Kirche, A., Tarquinio, C., & Brennstuhl, M. J. (2021). Posttraumatic Stress Disorder Following Myocardial Infarction: A Systematic Review. Journal of traumatic stress, 34(1), 190–199.