Intérêt et limites du concept de trouble de stress post-traumatique appliqué aux formes aiguës de cardiopathies ischémiques (infarctus du myocarde) : une réflexion épistémologique

Abstract

Over the past thirty years, the results of a large number of studies have shown that the occurrence of an acute cardiovascular event, such as myocardial infarction, can lead to the development of symptoms of post-traumatic stress disorder (PTSD) or post-traumatic stress disorder (PTSD), which in turn contribute to an impairment in quality of life, psychological health and increase the risk of cardiovascular adverse events and death. However useful and interesting it may be, PTSD should be considered as a nosographic entity sufficiently adapted to account, on its own, for traumatic disorders related to acute coronary events? To answer to this question, we will first explain why an acute cardiovascular event, such as a myocardial infarction, cannot be considered a potentially traumatic event “like any other”: we will describe its specific features. In a second step, we will show that people who have survived to myocardial infarction present traumatic difficulties for which the symptomatology of post-traumatic stress, as defined by the DSM-5, does not fully reflect. Finally, and given the limitations of the concept of PTSD in addressing the complexity of psychological trauma in the field of psycho-cardiology, and more specifically in the context of acute forms of ischemic heart disease, we will propose some avenues for reflection aimed at enriching the conceptualization of psychological trauma in this field.