Case reports
Can a psychiatrist be helpful for a cardiologist?

The paper presents four cases of mental disorders in cardiac patients. The first patient, treated for decompensated heart failure, continued to report coronary-like symptoms despite significant improvement of heart contractility. The second one underwent artificial pacemaker implantation due to bradycardia and heart block. The patient still suffered from distinct weakness with lowered mood. In the third case, a patient with long-term ischemic heart disease underwent successful invasive treatment for myocardial infarction, but after a few months his symptoms relapsed in the form of what he himself interpreted as angina pectoris. The last described patient was referred by her GP because of breathing difficulties and fatigue. In all the described cases, depression was diagnosed, and successful psychiatric treatment was implemented.

Discussion: In all the described cases, the symptoms persisted and worsened the patients’ comfort despite achieving objective improvement. This alarmed the attending physicians and could have resulted in unnecessary treatment modifications. Paying attention to the psychopathological aspects of the heart diseases enabled the physicians to diagnose the present mental disorders, employ efficacious treatment, and significantly improve the patients’ comfort.