Treating Anxiety Disorders in Patients with Cardiovascular Disease: How to Formulate Exposure Therapy When Anxiety Mimics the Heart

Abstract

<p>Patients with cardiovascular disease (CVD) routinely experience panic-like symptoms of shortness of breath, chest pain, and palpitations but also face high medical risk when ignoring chest pain symptoms and delaying seeking medical attention. When devising exposure therapy for anxiety in a patient with known heart disease, cognitive restructuring associated with exposure therapy requires adaption to incorporate this element of risk. Moreover, certain interoceptive symptom induction experiments may be harmful and lead to cardiopathogenesis. This chapter will therefore outline approaches to exposure therapy for anxiety when CVD is a known and medically verified comorbidity. Specifically, this chapter overviews literature pertinent to understanding common symptoms of CVDs and those overlapping with anxiety disorders. Different exposure-based therapy models are described along with required adaptions to safely and successfully undertake exposure therapy in patients with CVD.</p>