Depression and cardiac disease.

The relationship of mood disorders to cardiovascular disease is receiving considerable attention. The literature on diagnosing depression in patients with cardiovascular disease (CVD), is briefly summarized. There is overwhelming evidence that major depression and other mood disorders, though common, are underdiagnosed and undertreated in patients with coronary artery disease (CAD). This is of paramount importance because depression appears to be a major risk factor in both the development of CAD and in death after myocardial infarction. The pathophysiological alterations in depression that may underlie vulnerability to cardiovascular disease are reviewed with a focus on alterations in heart rate variability and platelet aggregation. The studies on treatment of depression in patients with CAD are also summarized. Treatment of depression in CAD patients appears to be effective, improves quality of life, and might increase longevity.