Heart heals the heart

Comments that the intangibles of the heart are important in determining a heart patient's ability to function.How nonbiomedical elements are so crucial that cardiologist are reshaping rehabilitation programs to encompass them; University of Washington's study on the severity of coronary artery disease; Distinctions between support that enables and that which disables.

By PT Staff, published on November 01, 1994

Cardiac Patients

It's not just tissue damage and blocked arteries that determine a heart patient's ability to function. The intangibles of the heart are just as important.

In fact, such nonbiomedical elements as the emotional support of a spouse, feelings of self-efficacy, and absence of depression and anxiety are so crucial that cardiologists are reshaping rehabilitation programs to encompass them.

Perhaps the most stunning news comes from the University of Washington, where an ongoing study finds that the severity of coronary artery disease is a poor predictor of a patient's physical impairment. Psychiatrist Mark Sullivan, M.D., told the American Psychiatric Association that even when arteries were blocked as much as 70 percent in 231 heart patients aged 45-80, factors like depression, anxiety, a sense of self-efficacy, and the type of spousal support were better predictors of function.

It is surprising that unconditional support from a spouse is not always the best medicine. There's an important distinction between support that enables and that which disables. Putting a spouse to bed and waiting on him hand and foot does not actually help him, says Sullivan. "This is similar to our findings in chronic pain patients."

The best support may be a listening ear, according to cardiologist Martin Sullivan, M.D., who heads the Center for Living at Duke University. "Those patients who have a confidante do much better than those who don't."