The sudden changes caused by a severe medicial condition like a coronary artery disase can cause severe emotional disturbances and fears not only for the patient but his whole family.

It is well known that any kind of somatic disorder does not only have a psychological influence on the patient but also on his wife and children. The fear and emotional disturbances associated with the diagnostic and therapeutic process in a hospital are only one aspect.

The fear and uncertain course of the illness (threats about a possible myocardial infarction, secondary complications of the disease) or planned interventions for recovery (e.g. surgery like bypass surgery CABS or angioplasty PTCA) may also cause severe distress with worries and a lot of catastrophic concerns about the possible outcome and future.

The family has to adapt to the new situation. Due to the illness major impairments of the ability to work or maintain a usual routine in life may also influence the life of the partner. Many normal habits of life and nutrition may have to be changed. Some wifes do also feel responsible for their husband (e.g. controlling the medication and usual activities of the partner).

So life has to be organized in a new way - very often very much and with more and new responsibilities for the partner of the person with heart problems.

Most spouses feel alone in this situation. They do not get much support by relatives or the medical system. They think they have to cope with the misery alone. Very often the are able to adapt and to function - for some weeks or month. It is a rather common problem that women of patients with coronary heart diseases will develop an adjustment problem or any type of psychiatric problem (e.g. depression, anxiety disorders) some weeks or month after the sudden onset of the somatic disorder.

So it is important to include the partner in the medical rehabilitation. Sometimes a self-help group or medical information group will address the special problems of the spouse. However this is not the usual practice in most hospitals.

So it may be necessary to speak about the concerns and emotional trouble with the doctor. He might recommend a short term medication with an antidepressant (e.g. SSRI) to help to cope with the special stress situation or take some time to listen to the concerns.