We studied the impact of a first myocardial infarction or episode of unstable angina on four areas of subjective health: wellbeing, perceived functional status, body confidence and emotional symptoms. A questionnaire in which the patient was asked to compare status before and after hospital admission was given to 61 cardiac patients attending follow-up rehabilitation clinics.
Worries about health and fears of straining oneself were common in the 24 patients surveyed less than 3 months from discharge. But in patients over 3 months from discharge, sense of wellbeing was significantly improved post-infarction compared with pre-infarction: 86% of patients noting a change reported an improvement. Perceived family role performance was significantly improved, while confidence in work performance and general competence remained unchanged. The prevalences of depression, anxiety and worry were unchanged from pre to post attack, patients in whom these symptoms developed being off-set by patients who lost symptoms.
Previously-reported adverse sequelae of acute coronary disease may exaggerate the extent of the problem. Restriction of studies to neurotic symptoms and failure to compare pre and post attack periods may fail to elicit improvements in quality of life associated with rehabilitation and secondary prevention programmes.
Running Title: Subjective health in post-coronary patients