Citation

Zarifeh JA, Mulder RT, Kerr AJ, Chan CW, Bridgman PG. Intern. Med. J. 2012; 42(4): 369-373.

Affiliation

Psychiatric Consultation/Liaison Service, Canterbury DHB, Christchurch, New Zealand University of Otago, Christchurch, New Zealand Department of Cardiology, Middlemore Hospital, Auckland, New Zealand Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.

Copyright

(Copyright © 2012, John Wiley and Sons)

DOI

10.1111/j.1445-5994.2012.02743.x

PMID

22356536

Abstract

Aims:  To compare psychological factors in patients presenting to hospital with earthquake induced stress cardiomyopathy, myocardial infarction and non-cardiac chest pain. We hypothesised that patients with stress cardiomyopathy and non-cardiac chest pain would be more psychologically vulnerable than those with myocardial infarction. Methods:  Cardiology admitting staff in the week following the September 2010 Christchurch earthquake prospectively identified patients with earthquake precipitated chest pain. Males were excluded. All consenting women met diagnostic criteria for one of the three conditions. Patients underwent a semi-structured interview with a senior clinical psychologist who was blind to the cardiac diagnosis. Pre-morbid psychological factors, experience of the earthquake and psychological response were assessed using a range of validated tools. Results:  Seventeen women were included in the study, six with stress cardiomyopathy, five with myocardial infarction and six with non-cardiac chest pain. Earthquake experiences were notably similar across the groups. Patients with non-cardiac chest pain scored high on the HADS anxiety scale, the health anxiety questionnaire, the Eysenck neuroticism scale and the Impact of Event scale. Women with stress cardiomyopathy scored as the most psychologically robust. Depression and extroversion scores were the same across groups. Conclusion:  Our hypothesis was incorrect. Women with non-cardiac chest pain following an earthquake have higher anxiety and neuroticism scores than women with either MI or stress cardiomyopathy. Stress cardiomyopathy following an earthquake is not specific to psychologically vulnerable women. The psychology of natural disaster induced stress cardiomyopathy may differ from that of sporadic cases.

Language: en