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Fear of Dying During Heart Attack May Make Matters Worse
Date:6/2/2011

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, June 1 (HealthDay News) -- People who become very afraid of dying in the moments during and days after a heart attack also seem to have more inflammation, an indicator that they may, in the long run, do worse than patients who are less fearful, a small British study suggests.

The finding, published online June 1 in the European Heart Journal, "reminds us of the connection between the mind and the body," said Dr. Suzanne Steinbaum, a preventive cardiologist with Lenox Hill Hospital in New York City.

"This trial shows us that when patients are so fearful, there's an increase in inflammation and decrease in heartbeat variability, which could lead to poor outcomes. So we must address not only the body issues but the mind issues as well," she said.

Added Dr. Robert Gramling, associate professor of family medicine at the University of Rochester Medical Center in New York: "This and the vast literature related to emotions and mind/body interactions are confirmatory that understanding people's emotional response does interplay with the biologic mechanisms. I believe, yes, attending to emotions is extraordinarily important, not only for the well-being of the individual's emotional and mental health but also for physical health and maybe even evolution of myocardial infarction [a heart attack]."

For the new study, researchers assessed 208 patients who had come to St. George's Hospital in London with acute coronary syndrome -- blockage of the coronary arteries -- during an 18-month time frame. They were asked during their hospital stay about their fear of dying. At the same time, the researchers also measured blood levels of tumor necrosis factor (TNF), which is involved in triggering inflammation.

Three weeks later, the researchers visited patients in their homes and measured heart rate variability and levels of the stress hormone cortisol in the saliva
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