{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:32:20Z","timestamp":1790652740834,"version":"4.1.0"},"reference-count":77,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T00:00:00Z","timestamp":1574640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Survivors of acute cardiovascular disease (CVD) events, such as acute coronary syndrome (ACS) and stroke, may experience significant psychological distress during and following the acute event. Long\u2010term adverse effects may follow, including the development of posttraumatic stress disorder (PTSD), increased overall all\u2010cause mortality, and recurrent cardiac events. The goal of this concepts paper is to describe and summarize the rates of adverse psychological outcomes, such as PTSD, following cardiovascular emergencies, to review how these psychological factors are associated with increased risk of future events and long\u2010term health and to provide a theoretical framework for future work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A panel of two board\u2010certified emergency physicians, one with a doctorate in experimental psychology, along with one PhD clinical psychologist with expertise in psychoneuroendocrinology were co\u2010authors involved in the paper. Each author used various search strategies (e.g., PubMed, Psycinfo, Cochrane, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A meta\u2010analysis of 24 studies (<jats:italic>N<\/jats:italic>\u00a0&gt;\u00a02,300) found the prevalence of ACS\u2010induced PTSD at nearly 12%, while a meta\u2010analysis of nine studies (<jats:italic>N<\/jats:italic>\u00a0=\u00a01,138) found that 25% of survivors of transient ischemic attack and stroke report PTSD symptoms. The presence of PTSD doubles 3\u2010year risk of CVD\/mortality risk in ACS survivors. Cardiac patients treated during periods of ED overcrowding, hallway care, and perceived poor clinician\u2013patient communication appear at greater risk for subsequent PTSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Psychological stress is often present in patients undergoing evaluation for acute CVD events. Understanding such associations provides a foundation to appreciate the potential contribution of psychological variables on acute and long\u2010term cardiovascular recovery, while also stimulating future areas of research and discovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13882","type":"journal-article","created":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T20:24:03Z","timestamp":1572639843000},"page":"71-79","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Stressing Out About the Heart: A Narrative Review of the Role of Psychological Stress in Acute Cardiovascular Events"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5693-190X","authenticated-orcid":false,"suffix":"Jr.","given":"Paul I.","family":"Musey","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Schultebraucks","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Columbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8800-7140","authenticated-orcid":false,"given":"Bernard P.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Columbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_6_3_1","first-page":"e38\u2013360","article-title":"Heart disease and stroke statistics\u20102016 update: a report from the American Heart Association","volume":"133","author":"Mozaffarian D","year":"2016","journal-title":"Circulation"},{"key":"e_1_2_6_4_1","unstructured":"RuiP KangK AshmanJJ.National Hospital Ambulatory Medical Care Survey: 2016 Emergency Department Summary Tables. 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