Depressive symptoms are highly prevalent in patients with cardiac diseases. Co-morbid
Depression in cardiac patients causes a significant reduction in health-related quality of life for the
patients and inflicts an economic burden on the society. Two types of mechanisms that may explain
the link between depression and cardiac diseases are the psychosocial and physiopathological
mechanisms. Physiopathological mechanisms are direct biological mechanisms, which include hyperactivity
of non-adrenergic and Hypothalamic Pituitary Adrenal Axis (HPA), abnormal platelet
activation, endothelial dysfunction, and inflammatory process. Psychosocial factors include behavioral
or lifestyle factors like smoking alcoholism and physical inactivity. Pharmacologic and therapeutic
interventions are effective at reducing symptoms of depression in patients with cardiac disorders.
Among pharmacological treatment, SSRIs seems to be effective for the reduction of depressive
symptoms among patients with cardiac disorders because of their good efficacy and minimal
cardiovascular side effects. Mechanisms of action of SSRI’s in depressive patients with cardiac
disorders are associated with their ability to reduce inflammation, platelet, and endothelial dysfunction.
This review focuses on the potential pathophysiological and psychosocial links between cardiac
diseases and depression, the treatment options, and the importance of routine screening of depressive
symptoms in cardiac settings.
Keywords: Depression, endothelial dysfunction, hypothalamic pituitary adrenal axis, inflammatory process, platelet activation,
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