A qualitative study of anxiety and depression following a heart attack in the United Kingdom
Abstract
Background: Heart attacks affect around 100,000 individuals annually in the United Kingdom (UK) and represent a significant public health burden. Survivors may develop depression and anxiety, with prevalence estimates of up to 24% and 12% respectively, increasing mortality risk. Despite this burden, mental health support is rarely embedded within cardiac recovery pathways, and no qualitative study in the UK has examined how survivors experience these symptoms.
Methods: Twenty heart attack survivors reporting anxiety or depression were recruited through cardiovascular charities and completed semi-structured interviews with a mean duration of 69 minutes. Data were analysed using reflexive thematic analysis with a critical realist approach.
Results: Four themes and ten subthemes were developed. Survivors described a trajectory from traumatic experience through anxiety driven by fear and uncertainty to depression linked to loss of identity. Social disconnection and unexpected career loss compounded emotional recovery. Emotional distress was routinely dismissed within cardiac care, generating internalised stigma and discouraging help-seeking. Protective factors were identified at individual levels, including health knowledge; service levels, including empathetic follow-up and peer support; and societal levels, including awareness and financial support.
Conclusions: Heart attack survivors may experience a complex survivorship process, yet the emotional impact is often overlooked. Anxiety and depression were shaped by individual, social, and healthcare-related factors, representing a significant public mental health concern. There is a need for flexible psychosocial support embedded within cardiac recovery pathways across multiple levels, including peer networks, empathetic healthcare follow-up, and financial support. Our study provides a foundation for developing survivor-centred interventions that prioritise mental health within cardiac care.
Key messages: • Heart attack survivors experience complex anxiety and depression shaped by trauma, social disconnection, and inadequate emotional support within cardiac care.
• Psychosocial interventions must operate across individual, service, and societal levels to address survivors’ unmet psychological needs.
Related
- Longitudinal Changes in Anxiety and Depression Following First Implantable Cardioverter-Defibrillator Implantation: A Prospective Observational Study
- The effect of preoperative hospital anxiety and depression scale evaluation on the clinical outcomes following posterior lumbar interbody fusion
- Insomnia and anxiety exhibit distinct short-term associations following ketamine in treatment-resistant depression
- Longitudinal trajectories of benefit finding and its associations with emotion regulation, social connectedness, depression, and anxiety among Chinese college students following the removal of COVID-19 restrictions. a multivariate latent growth curve analysis
- Feasibility and Pre-Post Changes in Depression, Anxiety, and Functional Independence Following a Combined Yoga, Meditation, and CBT Intervention for Adults with Spinal Cord Injury
BibTeX
@article{brenescastillo2026qualitative,
title = {{A qualitative study of anxiety and depression following a heart attack in the United Kingdom}},
author = {F Brenes-Castillo and U Foye and K Forristal and M Herle and HMS Zavos},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1976},
url = {https://doi.org/10.1093/eurpub/ckag169.1976},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A qualitative study of anxiety and depression following a heart attack in the United Kingdom
AU - F Brenes-Castillo
AU - U Foye
AU - K Forristal
AU - M Herle
AU - HMS Zavos
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1976
UR - https://doi.org/10.1093/eurpub/ckag169.1976
AB - Background: Heart attacks affect around 100,000 individuals annually in the United Kingdom (UK) and represent a significant public health burden. Survivors may develop depression and anxiety, with prevalence estimates of up to 24% and 12% respectively, increasing mortality risk. Despite this burden, mental health support is rarely embedded within cardiac recovery pathways, and no qualitative study in the UK has examined how survivors experience these symptoms. Methods: Twenty heart attack survivors reporting anxiety or depression were recruited through cardiovascular charities and completed semi-structured interviews with a mean duration of 69 minutes. Data were analysed using reflexive thematic analysis with a critical realist approach. Results: Four themes and ten subthemes were developed. Survivors described a trajectory from traumatic experience through anxiety driven by fear and uncertainty to depression linked to loss of identity. Social disconnection and unexpected career loss compounded emotional recovery. Emotional distress was routinely dismissed within cardiac care, generating internalised stigma and discouraging help-seeking. Protective factors were identified at individual levels, including health knowledge; service levels, including empathetic follow-up and peer support; and societal levels, including awareness and financial support. Conclusions: Heart attack survivors may experience a complex survivorship process, yet the emotional impact is often overlooked. Anxiety and depression were shaped by individual, social, and healthcare-related factors, representing a significant public mental health concern. There is a need for flexible psychosocial support embedded within cardiac recovery pathways across multiple levels, including peer networks, empathetic healthcare follow-up, and financial support. Our study provides a foundation for developing survivor-centred interventions that prioritise mental health within cardiac care. Key messages: • Heart attack survivors experience complex anxiety and depression shaped by trauma, social disconnection, and inadequate emotional support within cardiac care. • Psychosocial interventions must operate across individual, service, and societal levels to address survivors’ unmet psychological needs.
SN - 1101-1262
SN - 1464-360X
ER -