1. Dr Parul Tank MD DNB DPM MRCPsych Consultant Psychiatrist, Asian Heart Hospital Head of Department, Rajawadi Hospital, Mumbai

2. Out of the cardiac experience, life can become richer, more meaningful, and even joyous. Heart disease does not have to be only an ending. It can be a new beginning. Rhoda Levin Heartmates

3. Heart Heart is linked with emotions It also a main source of life Cardiac patients feel more distressed than others Physical symptoms similar to psychological symptoms

4. Immediate post op symptoms Less sleep Irritability Mild disorientation Mild memory lapses Fear and anxiety

5. Depression It is a normal reaction and self limiting It is due to overload of emotional and physical stresses Reduces quality of life Seen in 12 to 52% patients post op Increases risk of readmission and even mortality

6. Common symptoms Low mood Tearfulness Lack of interest, ideas of hopelessness and helplessness Anger, irritable Decrease sleep and appetite Body symptoms Feeling of suicide

7. Anxiety Feeling of fear and uncertainity “Ghabrahat” Mild to severe 15 to 45 % of post op patients

8. Anxiety Common symptoms include Uneasiness Irritable Physical symptoms like chest pain, headaches, diarrhoea, dryness of mouth, tremors, palpitations

9. Reasons Past history of emotional problems History of alcoholism, drugs Poor family or social support Anxious personality Certain medications Fear of the unknown /death

10. Practical tips Recognise the emotions Seek more information about the surgery and any other questions

11. Lifestyle changes Give time to heal – be patient Stop alcohol, nicotine Follow a healthy diet Enjoy social activities Do physical activities Accept negative feelings – do self talk Relaxation techniques Seek help if needed

12. The family It can be a stressful time for family Meet patient even if disoriented Give reasurance Seek help if you are anxious or depressed Treat patient with care but not overconcern Take time out Avoid guilt feelings

13. Take a Chill Pill Thank you!