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Post-traumatic Stress Disorder and Cardiovascular Disease

  • Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)
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Abstract

Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, text revision. 4th ed. Washington: American Psychiatric Association; 2000.

    Google Scholar 

  2. Schnurr PP, Lunney CA, Bovin MJ, Marx BP. Posttraumatic stress disorder and quality of life: extension of findings to veterans of the wars in Iraq and Afghanistan. Clin Psychol Rev. 2009;29:727–35.

    Article  PubMed  Google Scholar 

  3. Rapaport MH, Clary C, Fayyad R, Endicott J. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005;162:1171–8.

    Article  PubMed  Google Scholar 

  4. Edmondson E, Kronish IM, Shaffer JA, Falzon L, Burg MM. Posttraumatic stress disorder and risk for coronary heart disease: a meta-analytic review. Am Heart J. 2013;166:806–14. This meta-analysis of 6 studies with overall pool of over 400,000 participants determined that PTSD increases risk for early incident CVD and CVD mortality, independent of depression, which is often co-morbid with PTSD. Of note, the pool of studies and participants included both military veterans and civilians.

    Article  PubMed  Google Scholar 

  5. Dong M, Giles WH, Felitti VJ, Dube SR, Williams JE, Chapman DP, et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation. 2004;110:1761–6.

    Article  PubMed  Google Scholar 

  6. Sachs-Ericsson N, Blazer D, Plant EA, Arnow B. Childhood sexual and physical abuse and the 1-year prevalence of medical problems in the National Comorbidity Survey. Health Psychol. 2005;24:32–40.

    Article  PubMed  Google Scholar 

  7. Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. Medical comorbidity of full and partial posttraumatic stress disorder in United States adults: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. 2011;73:697–707.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mcfarlane AC, Atchison M, Rafalowicz E, Papay P. Physical symptoms in post-traumatic stress disorder. J Psychosom Res. 1994;38:715–26.

    Article  CAS  PubMed  Google Scholar 

  9. Spitzer C, Barnow S, Völzke H, John U, Freyberger HJ, Grabe HJ. Trauma, posttraumatic stress disorder, and physical illness: findings from the general population. Psychosom Med. 2009;71:1012–7.

    Article  PubMed  Google Scholar 

  10. Sareen J, Cox BJ, Stein MB, Afifi TO, Fleet C, Asmundson GJ. Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosom Med. 2007;69:242–8.

    Article  PubMed  Google Scholar 

  11. Sawchuk CN, Roy-Byrne P, Goldberg J, Manson S, Noonan C, Beals J, et al. The relationship between post-traumatic stress disorder, depression and cardiovascular disease in an American Indian tribe. Psychol Med. 2005;35:1785–94.

    Article  PubMed  Google Scholar 

  12. Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. Prevalence and axis 1 comorbidity of full and partial posttraumatic stress disorder in the United States: results from wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions. J Anxiety Disord. 2011;25:456–65.

    Article  PubMed  Google Scholar 

  13. Ahmadi N, Hajsadeghi F, Mirshkarlo HB, Budoff M, Yehuda R, Ebrahimi R. Post-traumatic stress disorder, coronary atherosclerosis, and mortality. Am J Cardiol. 2011;108:29–33.

    Article  PubMed  Google Scholar 

  14. Boscarino JA. Posttraumatic stress disorder and mortality among U.S. army veterans 30 years after military service. Ann Epidemiol. 2006;16:248–56.

    Article  PubMed  Google Scholar 

  15. Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70:668–70.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kubzansky LD, Koenen KC, Spiro III A, Vokonas PS, Sparrow D. Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study. Arch Gen Psychiatry. 2007;64:109–16.

    Article  PubMed  Google Scholar 

  17. Kibler JL, Joshi K, Ma M. Hypertension in relation to posttraumatic stress disorder and depression in the US national comorbidity study. Behav Med. 2008;34:125–31.

    Article  Google Scholar 

  18. Kibler JL. Posttraumatic stress and cardiovascular disease risk. J Trauma Dissociation. 2009;10:135–50.

    Article  PubMed  Google Scholar 

  19. Cohen BE, Marmar C, Ren L, Bertenthal D, Seal KH. Association of cardiovascular risk factors with mental health diagnoses in Iraq and Afghanistan war veterans using VA health care. JAMA. 2009;302:489–92.

    Article  CAS  PubMed  Google Scholar 

  20. Andersen J, Wade M, Possemato K, Ouimette P. Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans. Psychosom Med. 2010;72:498–504.

    Article  PubMed  Google Scholar 

  21. Granado NS, Smith TC, Swanson GM, Harris RB, Shahar E, Smith B, et al. Newly reported hypertension after military combat deployment in a large population-based study. Hypertension. 2009;54:966–73.

    Article  CAS  PubMed  Google Scholar 

  22. Burg MM, Brandt C, Buta E, Schwartz J, Bathulapalli H, Dziura J, et al. Risk for incident hypertension associated with PTSD in military veterans, and the effect of PTSD treatment. Psychosom Med. 2016. This study utilized a national data set of recent US military veterans and demonstrated that PTSD independently increases risk for early incident hypertension. It furthermore raised questions as to whether PTSD treatment affects this risk.

  23. Abouzeid M, Kelsall HL, Forbes AB, Sim MR, Creamer MC. Posttraumatic stress disorder and hypertension in Australian veterans of the 1991 Gulf War. Pychosom Res. 2012;72:33–8.

    Article  Google Scholar 

  24. Pietrzak RH, Feder A, Singh R, Schechter CB, Bromet EJ, Katz CL, et al. Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study. Psychol Med. 2014;44:205–19.

    Article  CAS  PubMed  Google Scholar 

  25. Calhoun PS, Elter JR, Jones Jr ER, Kudler H, Straits-Tröster K. Hazardous alcohol use and receipt of risk-reduction counseling among U.S. veterans of the wars in Iraq and Afghanistan. J Clin Psychiatry. 2008;69:1686–93.

    Article  PubMed  Google Scholar 

  26. Smith B, Ryan MAK, Wingard DL, Patterson TL, Slymen DJ, Macera CA. Cigarette smoking and military deployment: a prospective evaluation. Am J Prev Med. 2008;35:539–46.

    Article  PubMed  Google Scholar 

  27. Breslau N, Davis GC, Schultz LR. Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Arch Gen Psychiatry. 2003;60:289–94.

    Article  PubMed  Google Scholar 

  28. Dedert EA, Calhoun PS, Harper LA, Dutton CE, McClernon FJ, Beckham JC. Smoking withdrawal in smokers with and without posttraumatic stress disorder. Nicotine Tob Res. 2012;14:372–6.

    Article  PubMed  Google Scholar 

  29. Barber J, Bayer L, Pietrzak RH, Sanders KA. Assessment of rates of overweight and obesity and symptoms of posttraumatic stress disorder and depression in a sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans. Mil Med. 2011;176:151–5.

    Article  PubMed  Google Scholar 

  30. Cohen BE, Marmar CR, Neylan TC, Schiller NB, Ali S, Whooley MA. Posttraumatic stress disorder and health-related quality of life in patients with coronary heart disease: findings from the Heart and Soul Study. Arch Gen Psychiatry. 2009;66:1214–20.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Buckley TC, Mozley SL, Bedard MA, Dewulf AC, Greif J. Preventive health behaviors, health risk behaviors, physical morbidity, and health-related role functioning impairment in veterans with post-traumatic stress disorder. Mil Med. 2004;169:536–40.

    Article  PubMed  Google Scholar 

  32. Zen AL, Whooley MA, Zhao S, Cohen BE. Post-traumatic stress disorder is associated with poor health behaviors: findings from the Heart and Soul Study. Health Psychol. 2012;31:194–201.

    Article  PubMed  Google Scholar 

  33. Gehi AK, Ali S, Na B, Whooley MA. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease: the Heart and Soul Study. Arch Intern Med. 2007;167:1798–803.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kronish IM, Edmondson D, Li Y, Cohen BE. Post-traumatic stress disorder and medication adherence: results from the Mind Your Heart study. J Psychiatr Res. 2012;46:1595–9.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Maher MJ, Rego SA, Asnis GM. Sleep disturbances in patients with post-traumatic stress disorder: epidemiology, impact and approaches to management. CNS Drugs. 2006;20:567–90.

    Article  CAS  PubMed  Google Scholar 

  36. Orth U, Wieland E. Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: a meta-analysis. J Consult Clin Psychol. 2006;74:698–706.

    Article  PubMed  Google Scholar 

  37. Rozanski A, Blumenthal JA, Davidson KA, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice. J Am Coll Cardiol. 2005;45:637–51.

    Article  PubMed  Google Scholar 

  38. Davidson JR, Hughes D, Blazer DG, George LK. Post-traumatic stress disorder in the community: an epidemiological study. Psychol Med. 1991;21:713–21.

    Article  CAS  PubMed  Google Scholar 

  39. Beckham JC, Vrana SR, Barefoot JC, Feldman ME, Fairbank J, Moore SD. Magnitude and duration of cardiovascular responses to anger in Vietnam veterans with and without posttraumatic stress disorder. J Consult Clin Psychol. 2002;70:228–34.

    Article  PubMed  Google Scholar 

  40. Vanltallie TB. Stress: a risk factor for serious illness. Metabolism. 2002;51:40–5.

    Article  Google Scholar 

  41. Rasmusson AM, Hauger RL, Morgan CA, Bremner JD, Charney DS, Southwick SM. Low baseline and yohimbine-stimulated plasma neuropeptide Y (NPY) levels in combat-related PTSD. Biol Psychiatry. 2000;47:526–39.

    Article  CAS  PubMed  Google Scholar 

  42. Yehuda R. Advances in understanding neuroendocrine alterations in PTSD and their therapeutic implications. Ann N Y Acad Sci. 2006;1071:137–66.

    Article  CAS  PubMed  Google Scholar 

  43. Krystal JH, Neumesiter A. Noradrenergic and serotonergic mechanisms in the neurobiology of post traumatic stress disorder and resilience. Brain Res. 2009;1293:13–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Southwick SM, Morgan CA, Vythilingam M, Krystal JH, Charney DS. Emerging neurobiological factors in stress resilience. PTSD Res Q. 2003;14:1–3.

    Google Scholar 

  45. von Kanel R, Begre S, Abbas CC, Saner H, Gander M-L, Schmid J-P. Inflammatory biomarkers in patients with posttraumatic stress disorder caused by myocardial infarction and the role of depressive symptoms. Neuroimmunomodulation. 2010;17:39–46.

    Article  Google Scholar 

  46. von Känel R, Hepp U, Kraemer B, Traber R, Keel M, Mica L, et al. Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. J Psychiatr Res. 2007;41:744–52.

    Article  Google Scholar 

  47. Vidović A, Grubišić-Ilić M, Kozarić-Kovačić D, Gotovac K, Rakoš I, Markotić A, et al. Exaggerated platelet reactivity to physiological agonists in war veterans with posttraumatic stress disorder. Psychoneuroendocrinology. 2011;36:161–72.

    Article  PubMed  Google Scholar 

  48. Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in relaxation of the arterial smooth muscle by acetylcholine. Nature. 1980;288:273–6.

    Article  Google Scholar 

  49. Willerson JT, Kereiakes DJ. Endothelial dysfunction. Circulation. 2003;108:2060–1.

    Article  PubMed  Google Scholar 

  50. Verma S, Buchanan MR, Anderson TJ. Endothelial function testing as a biomarker of vascular disease. Circulation. 2003;108:2054–9.

    Article  PubMed  Google Scholar 

  51. Harris CW, Edwards JL, Baruch A, Riley WA, Pusser BE, Rejeski WJ, et al. Effects of mental stress on brachial artery flow-mediated vasodilation in healthy normal individuals. Am Heart J. 2000;139:405–11.

    CAS  PubMed  Google Scholar 

  52. Gottdiener JS, Kop WJ, Hausner E, McCeney MK, Herrington D, Krantz DS. Effects of mental stress on flow-mediated brachial arterial dilation and influence of behavioral factors and hypercholesterolemia in subjects without cardiovascular disease. Am J Cardiol. 2003;92:687–91.

    Article  PubMed  Google Scholar 

  53. Sarabi M, Lind L. Mental stress opposes endothelium-dependent vasodilation in young healthy individuals. Vasc Med. 2001;6:3–7.

    Article  CAS  PubMed  Google Scholar 

  54. Wilbert-Lampen U, Nickel T, Leistner D, Güthlin D, Matis T, Völker C, et al. Modified serum profiles of inflammatory and vasoconstrictive factors in patients with emotional stress-induced acute coronary syndrome during World Cup Soccer 2006. J Am Coll Cardiol. 2010;55:637–42.

    Article  CAS  PubMed  Google Scholar 

  55. Yang Z, Richard V, von Segresser L, Bauer E, Stulz P, Turina M, et al. Threshold concentrations of endothelin-1 potentiate contractions to norepinephrine and serotonin in human arteries. Circulation. 1990;82:188–95.

    Article  CAS  PubMed  Google Scholar 

  56. Arrighi JA, Burg M, Cohen IS, Kao AH, Pfau S, Caulin-Glaser T, et al. Myocardial blood-flow response during mental stress in patients with coronary artery disease. Lancet. 2000;356:310–1.

    Article  CAS  PubMed  Google Scholar 

  57. Ghiadoni L, Donald AE, Cropley M, Mullen MJ, Oakley G, Taylor M, et al. Mental stress induces transient endothelial dysfunction in humans. Circulation. 2000;102:2473–8.

    Article  CAS  PubMed  Google Scholar 

  58. Spieker LE, Hurlimann D, Ruschitzka F, Corti R, Enseleit F, Shaw S, et al. Mental stress induces prolonged endothelial dysfunction via endothelin-A receptors. Circulation. 2002;105:2817–20.

    Article  CAS  PubMed  Google Scholar 

  59. Shimbo D, Chaplin W, Akinola O, Harris A, Abraham D, Homma S, et al. Effect of anger provocation on endothelium-dependent and independent vasodilation. Am J Cardiol. 2007;99:860–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Finucane AM, Dima A, Ferreira N, Halvorsen M. Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals. Clin Psychol Psychother. 2012;19:14–24.

    Article  PubMed  Google Scholar 

  61. Fernandez AB, Soufer R, Collins D, Soufer R, Ranjbaran H, Burg MM. Tendency to angry rumination predicts stress-provoked endothelin-1 increase in patients with coronary artery disease. Psychosom Med. 2010;72:348–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Guler E, Schmid J-P, Wiedemar L, Saner H, Schnyder U, von Kanel R. Clinical diagnosis of posttraumatic stress disorder after myocardial infarction. Clin Cardiol. 2009;32:125–9.

    Article  PubMed  Google Scholar 

  63. Edmondson D, Rieckmann N, Shaffer JA, Schwartz JE, Burg MM, Davidson KW, et al. Posttraumatic stress due to an acute coronary syndrome increases risk of 42-month major adverse cardiac events and all-cause mortality. J Psychiatr Res. 2011;45:1621–6.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Merriman C, Norman P, Barton J. Psychological correlates of PTSD symptoms following stroke. Psychol Health Med. 2007;12:592–602.

    Article  PubMed  Google Scholar 

  65. Edmondson D, Richardson S, Falzon L, Davidson KW, Mills MA, Neria Y. Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review. PLoS ONE. 2012;7:e38915.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Wikman A, Bhattacharyya M, Perkins-Porras L, Steptoe A. Persistence of posttraumatic stress symptoms 12 and 36 months after acute coronary syndrome. Psychosom Med. 2008;70:764–72.

    Article  PubMed  Google Scholar 

  67. Roberge M-A, Dupuis G, Marchand A. Post-traumatic stress disorder following myocardial infarction: prevalence and risk factors. Can J Cardiol. 2010;26:e170–5.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Vaccarino V, Shah AJ, Rooks C, Ibeanu I, Nye JA, Pimple P, et al. Sex differences in mental stress-induced myocardial ischemia in young survivors of an acute myocardial infarction. Psychosom Med. 2014;76:171–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Ginzburg K, Ein-Dor T. Posttraumatic stress syndromes and health-related quality of life following myocardial infarction: 8-year follow-up. Gen Hosp Psychiatry. 2011;3:565–71.

    Article  Google Scholar 

  70. Shemesh E, Yehuda R, Milo O, Dinur I, Rudnick A, Vered Z, et al. Posttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction. Psychosom Med. 2004;66:521–6.

    Article  PubMed  Google Scholar 

  71. von Känel R, Hari R, Schmid JP, Wiedemar L, Guler E, Barth J, et al. Non-fatal cardiovascular outcome in patients with posttraumatic stress symptoms caused by myocardial infarction. J Cardiol. 2011;58:61–8.

    Article  Google Scholar 

  72. National Center for PTSD. Understanding PTSD treatment. August 2013 U.S. Department of Veterans Affairs | www.ptsd.va.gov.

  73. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC. Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:603–13.

    Article  PubMed  Google Scholar 

  74. Freedy JR, Steenkamp MM, Magruder KM, Yeager DE, Zoller JS, Hueston WJ, et al. Post-traumatic stress disorder screening test performance in civilian primary care. Fam Pract. 2010;27:615–24.

    Article  PubMed  Google Scholar 

  75. Kessler RC, Chin WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617–27.

    Article  PubMed  PubMed Central  Google Scholar 

  76. García-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH, WHO Multi-country Study on Women’s Health and Domestic Violence against Women Study Team. Prevalence of intimate partner violence: findings from the WHO Multi-country Study on Women’s Health and Domestic Violence. Lancet. 2006;368:1260–9.

    Article  PubMed  Google Scholar 

  77. Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, et al. Acute myocardial infarction in women: a scientific statement from the American Heart Association. Circulation. 2016;133:916–47.

    Article  CAS  PubMed  Google Scholar 

  78. Eguchi K, Pickering TG, Hoshide S, Ishikawa J, Ishikawa S, Schwartz JE, et al. Ambulatory blood pressure is a better marker than clinic blood pressure in predicting cardiovascular events in patients with/without type 2 diabetes. Am J Hypertens. 2008;21:443–50.

    Article  PubMed  Google Scholar 

  79. Carrel AL, McVean JJ, Clark RR, Peterson SE, Eickhoff JC, Allen DB. School-based exercise improves fitness, body composition, insulin sensitivity, and markers of inflammation in non-obese children. J Pediatr Endocrinol Metab. 2009;22:409–15.

    Article  PubMed  Google Scholar 

  80. Kinlay S, Schwartz GG, Olsson AG, Rifai N, Szarek M, Waters DD, et al. Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study. Arterioscler Thromb Vasc Biol. 2008;28:142–7.

    Article  CAS  PubMed  Google Scholar 

  81. McFall M, Saxon AJ, Malte CA, Chow B, Bailey S, Baker DG, et al. Integrating tobacco cessation into mental health care for posttraumatic stress disorder: a randomized controlled trial. JAMA. 2010;304:2485–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Germain A, Richardson R, Moul DE, Mammen O, Haas G, Forman SD, et al. Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US military veterans. J Psychosom Res. 2012;72:89–96.

    Article  PubMed  Google Scholar 

  83. Ulmer CS, Calhoun PS, Bosworth HB, Dennis MF, Beckham JC. Nocturnal blood pressure non-dipping, posttraumatic stress disorder, and sleep quality in women. Behav Med. 2013;39:111–21.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Irwin M, Wang M, Campomayor CA, Collado-Hidalgo A, Cole S. Sleep deprivation and activation of morning levels of cellular and genomic markers of inflammation. Arch Intern Med. 2006;166:1756–62.

    Article  CAS  PubMed  Google Scholar 

  85. Febbraio MA. Exercise and inflammation. J Appl Physiol. 2007;103:376–7.

    Article  CAS  PubMed  Google Scholar 

  86. Edmondson D, Shimbo D, Ye S, Wyer P, Davidson KW. Emergency department crowding during treatment for acute coronary syndrome predicts subsequent posttraumatic stress disorder symptoms. JAMA Intern Med. 2013;173:472–4. This paper demonstrated that for patients diagnosed with acute coronary syndrome (ACS), crowding in the emergency department during their stay for evaluation increases the likelihood that the patients will subsequently develop PTSD due to the trauma of ACS event. It thus indicates one pathway—reducing crowding—by which PTSD consequent to ACS can be prevented.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA

    Matthew M. Burg & Robert Soufer

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA

    Matthew M. Burg

  3. Section of Cardiovascular Medicine, VA Connecticut Healthcare System, West Haven, CT, USA

    Matthew M. Burg & Robert Soufer

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Matthew M. Burg and Robert Soufer declare that they have no conflict of interest.

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This article is part of the Topical Collection on Psychological Aspects of Cardiovascular Diseases

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Burg, M.M., Soufer, R. Post-traumatic Stress Disorder and Cardiovascular Disease. Curr Cardiol Rep 18, 94 (2016). https://doi.org/10.1007/s11886-016-0770-5

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