Abstract

Prolonged grief disorder (PGD) is characterized with core manifestations of preoccupation and yearning, or both, which could be associated with emotional instability, disturbances in identity, loss of purpose and meaning in life, along with impairment in function. This commentary aims to elaborate these characteristics in the light of biological mechanisms, predisposing cardiovascular diseases (CVDs).The prevalence of PGD varies between 3.4% to 9.8% in various studies. People with bereavement or PGD are at heightened risk of CVDs, including acute myocardial infarction (AMI), heart failure, mortality, stroke, atrial fibrillation and psychological disorders such as depression. Prolonged grief can cause increased sympathetic activity with high stress hormones leading to oxidative stress and inflammation, that potentially affects coronary and heart muscle function. Intense grief may cause physical problems and may trigger AMI, in people with higher baseline risk of CVDs. PGD -induced chronic low-grade inflammation may predispose vasoconstriction, arrhythmias, increase in platelet aggregation, increased pro-inflammatory cytokines and release of endothelin with increased production of fibrinogen known to promote plaque destabilization and a pro-thrombotic state, with involvement of certain regions of the brain.

Keywords

bereavement, grief, stress, inflammation, acute myocardial infarction