Evaluating Anxiety in Adults with Congenital Heart Disease Against Acquired Heart Disease Patients

According to Stephen C. Cook and colleagues, one-third of adults with congenital heart disease (CHD) are diagnosed with anxiety, a prevalence which is “11% higher than the general population.” In their report, presented at ACC.22, the collaborators suggested that pre-procedural anxiety could lead to “detrimental effects both cognitively and physiologically.” They set out to uncover associations between situational (state) and persistent (trait) anxiety in adults with CHD, and how those differ compared to those in adults with acquired heart diseases.

The authors’ article reported that persistent anxiety levels were significantly higher in patients with CHD compared to acquired heart disease populations, and they advised that “recognition of specific patient characteristics (younger age, CHD complexity) and stressors (financial stress) may help patients cope with procedural testing.”

Cook and colleagues used the State-Trait Anxiety Inventory and financial stress scale to assess a total of 291 patients, of which 91 were patients with CHD. In their regression analyses, the researchers found that the CHD group, compared to the acquired heart disease group, was more female (57% vs. 35.5%), younger (41.3 ± 16.3 vs. 64.7 ± 11.3 years; p <0.001), had more prior cardiac surgeries (p <0.001), and had higher trait anxiety with (t[171] = 2.62; p = 0.001; d = 0.33); although, state anxiety was comparable between groups. In both groups, “state anxiety was singularly associated with trait anxiety,” wrote Cook. He also reported that “trait anxiety was negatively associated with age and positively associated with financial stress and state anxiety.” A greater complexity of a patient’s CHD was also correlated with higher trait and state anxiety compared to simple or moderate CHD.

In closing, the study’s authors recommended that health care providers “must consider long-term psychological interventions, such as psychotherapy, and social interventions to be impactful at reducing pre-procedural anxiety,” and finally theorized that “effective psychosocial interventions may lead to faster recovery, improved well-being, and improved quality of life.”