BOSTON, MA – Post-traumatic stress disorder (PTSD) isn't limited to soldiers or witnesses of a horrifying event. It can also appear after a heart attack, a stroke, or heart surgery. Not only does PTSD cause emotional and psychological distress, it may also slow recovery and hasten the progression of heart disease, reports the August issue of the Harvard Heart Letter.

A special problem of heart-related PTSD is that the trauma comes from within. Sufferers are constantly on the alert for signs of an impending heart attack, such as a racing heart or shortness of breath. The trouble is, these are also normal responses to physical activity or stress. Some people with heart-related PTSD go to great lengths to avoid these reminders—they stop climbing stairs, making love, or doing other activities that make the heart beat faster. Some stop taking medications that remind them of the heart attack.

Four questions can help identify PTSD:

• Do you think about the event when you don’t want to?
• Do you avoid situations, thoughts, or feelings that remind you of it?
• Do you feel constantly on alert?
• Are you feeling detached from family and friends?

The Harvard Heart Letter notes that treating PTSD starts with talk therapy that aims to help a person come to terms with a traumatic event by conjuring up memories of it in a safe situation. Reconnecting with people, interests, and activities is another goal of therapy. Some people also benefit from taking an antidepressant.

The bottom line: Recognizing the signs of PTSD and getting help will be good for your heart, your health, and your life.