Effects of Mood Imbalance on Disrupting Coronary Circulation: A Correlation or Speculation?

Depression and Coronary Artery disease (CAD) are two highly prevalent diseases seen in general population which affect more than 264 million and 110 million adults worldwide respectively. Modifiable risk factors include smoking, hypertension, dyslipidemia, obesity and one other major risk factor that has caught many researchers' attention: psychological factors. Psychological factors, like depressive symptoms and stress, are known to have a significant effect on CAD. Many patients with CAD suffer from depression and it is believed that depression can increase the mortality rate in CAD. The objective of the current review is to assess the relation of depression and coronary artery disease, analyze different treatment options and determine a potential pathophysiological factor in causing depression in patients with CAD. We searched literature in PubMed with parallel MeSH and Regular Keyword strategy for data collection. Our PubMed search for keywords resulted in finding 5905 articles. After implementing our inclusion and exclusion criteria, a total number of 38 articles from PubMed were selected and reviewed. Our analysis showed that depression can increase chest pains and mortality rate in patients with CAD but on the other hand, patients with CAD were more likely to show depressive symptoms. These patients benefit from cardiac rehabilitation program, Mindfulness-based art therapy and use of Serotonin-norepinephrine reuptake inhibitors (SNRIs). We also found that Sphingolipids are potentially playing a major role in these diseases' pathophysiology.