Psychological Adaptation to Acute and Chronic Heart Disease

  • W. Doyle Gentry
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 31)


Coronary heart disease (CHD) is a major cause of disability and death in the United States, especially for persons over 50 years of age and for the elderly [1]. This is true for both men and women, despite the fact that men tend to evidence more CHD than women at any age by a ratio of 2:1. Statistics from the Framingham Heart Study (figure 14-1) show, for example, that by age 60 every fifth man will have already developed CHD (as indicated by angina pectoris, myocardial infarction, coronary insufficiency, or coronary death); 1 in 17 women will also be affected by CHD at 60 years of age. Offsetting this rather pessimistic statistic, however, is the fact that there has been a noticeable decline in CHD mortality over the past 10 to 15 years. Irrespective of the reasons behind this drop in CHD death rates, it now seems clear that an increasing percentage of persons suffering an acute episode of CHD will, in fact, survive and will then be faced with the prospect of altering their premorbid life-style to accommodate their illness. This change in life-style, depending on the severity and complexity of the CHD event, may be reflected in day-to-day work habits, sexual function, social and recreational activities, relationship with spouse and family, and even personality [2–6]. Such change calls forth strategies for coping and new behaviors for short- and long-term adaptation to illness, some of which are clearly successful (for example, compliance with medical regimen) and others (for example, denial) that lead to maladjustment and often to increased risk of further episodes of CHD and/or death. In this
Figure 14-1

Fourteen-year incidence of CHD (all clinical manifestations) according to age and sex, men and women aged 30 to 62 years at entry: Framingham Heart Study. (Reproduced with permission from Castelli WP, in Long C (ed). Prevention and Rehabilitation in Ischemic Heart Disease,Williams & Wilkins, 1980, 1–17.)

chapter, we will consider those aspects of psychological adaptation to CHD that are particularly germane to the elderly patient, as well as those patients who are at what might be called the pre-elderly or transition phase of life (50 to 59 years) when they first experience some manifestation of CHD.


Coronary Heart Disease Acute Myocardial Infarction Sexual Function Heart Attack Cardiac Rehabilitation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Castelli WP. Cardiovascular statistics in the United States: Framingham and beyond. In C. Long (ed), Prevention and Rehabilitation in Ischemic Heart Disease. Baltimore: Williams and Wilkins, 1980, pp 1–17.Google Scholar
  2. 2.
    Cromwell RL, Butterfield EC, Brayfield FM, and Curry JJ. Acute Myocardial Infarction: Reaction and Recovery. St. Louis: Mosby, 1977.Google Scholar
  3. 3.
    Croog SH and Levine S. Life After a Heart Attack: Social and Psychological Factors Eight Years Later. New York: Human Sciences Press, 1982.Google Scholar
  4. 4.
    Gentry WD. Psychosocial concerns and benefits in cardiac rehabilitation. In ML Pollock and DH Schmidt (eds), Heart Disease and Rehabilitation. Boston: Houghton Mifflin, 1979, pp. 690–700.Google Scholar
  5. 5.
    Gentry WD and Williams RB (eds). Psychological Aspects of Myocardial Infarction and Coronary Care, 2nd ed. St. Louis: Mosby, 1979.Google Scholar
  6. 6.
    Williams RB and Gentry WD. Psychological problems inherent in the cardiopathic state. In C. Long (Ed.), Prevention and Rehabilitation in Ischemic Heart Disease. Baltimore: Williams & Wilkins, 1980, pp 106–128.Google Scholar
  7. 7.
    Monteiro, LA. After heart attack: Behavioral expectations for the cardiac. Soc Sci Med 7: 555–565, 1973.PubMedCrossRefGoogle Scholar
  8. 8.
    Rosen JL and Bibring GL. Psychological reactions of hospitalized male patients to a heart attack: Age and social-class differences. Psychosom Med 28: 808–821, 1966.Google Scholar
  9. 9.
    Groden BM. Return to work after myocardial infarction. Scot Med J 12: 297–301, 1967.PubMedGoogle Scholar
  10. 10.
    Weinblatt E, Shapiro R, Frank CW, et al. Return to work and work status following first myocardial infarction. Am J Public Health 56: 169–185, 1966.CrossRefGoogle Scholar
  11. 11.
    Wenger NK, Hellerstein HK, Blackburn H, et al. Uncomplicated myocardial infarction: Current physician practice in patient management. JAMA 224: 511–514, 1973.PubMedCrossRefGoogle Scholar
  12. 12.
    Nagle R, Gangola R, and Picton-Robinson I. Factors influencing return to work after myocardial infarction. Lancet 2: 454–456, 1971.PubMedCrossRefGoogle Scholar
  13. 13.
    Wishnie HA, Hackett TP, and Cassem NH. Psychological hazards of convalescence following myocardial infarction. JAMA 215: 1292–1296, 1971.PubMedCrossRefGoogle Scholar
  14. 14.
    Wynn A. Unwarranted emotional distress in men with ischemic heart disease. Med J Aust, 2: 847–851, 1967.PubMedGoogle Scholar
  15. 15.
    Hellerstein HK and Friedman EH. Sexual activity and the post-coronary patient. Arch Intern Med, 125: 987–999, 1970.PubMedCrossRefGoogle Scholar
  16. 16.
    Dembroski TM, Weiss SM, Shields JL, et al. (eds). Coronary-prone Behavior. New York: Springer-Verlag, 1978.Google Scholar
  17. 17.
    Gentry WD, Oude-Weme JD, Musch F, and Hall RP. Differences in types A and B behavior in response to acute myocardial infarction. Heart Lung 10: 1101–1105, 1981.PubMedGoogle Scholar
  18. 18.
    Gentry WD, Baider L, et al. Type A/B differences in coping with acute myocardial infarction: Further considerations. Heart Lung 12: 212–214, 1983.PubMedGoogle Scholar
  19. 19.
    Gentry WD and Haney T. Emotional and behavioral reaction to acute myocardial infarction. Heart Lung 4: 738–745, 1975.PubMedGoogle Scholar
  20. 20.
    Moss AJ, Wynar B, and Goldstein S. Delay in hospitalization during the acute coronary period. Am J Cardiol 24: 659–665, 1969.PubMedCrossRefGoogle Scholar
  21. 21.
    Gruen W. Effects of brief psychotherapy during the hospitalization period on the recovery process in heart attacks. J Consult Clin Psychol 43: 223–232, 1975.PubMedCrossRefGoogle Scholar
  22. 22.
    Mone L. Short-term group psychotherapy with post-cardiac patients. Int J Group Psychother 20: 99–108, 1970.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • W. Doyle Gentry

There are no affiliations available

Personalised recommendations