2007 Heart-Brain summit proceedings

Case study in heart-brain interplay: A 53-year-old woman recovering from mitral valve repair

Leo Pozuelo, MD,

Departments of Psychiatry & Psychology, Cardiovascular Medicine and Associate Director, Bakken-Heart Brain Institute, Cleveland Clinic, Cleveland, OH

pozuell@ccf.org.

 

Thomas D. Callahan, IV, MD
Department of Cardiovascular Medicine,
Cleveland Clinic, Cleveland, OH

 

Ubaid Khokhar, MD
Department of Psychiatry and Psychology,
Cleveland Clinic, Cleveland, OH

ABSTRACT

This article presents the case of a 53-year-old female attorney who underwent successful mitral valve repair for mitral valve prolapse. The patient's postoperative course was marked by refractory pain, fatigue, shortness of breath, refusal to ambulate, frequent episodes of tearfulness, and a postsurgical decline in ejection fraction through postoperative week 4. Her slow recovery prompted a psychiatric consult, during which she reported panic and a fear of "losing it.‚" After respective presentations of the case from the cardiology and psychiatry perspectives, the article concludes with a moderated discussion of the case to explore insights it provides into heart-brain interactions.