Differentiating cognitive impairment from symptoms of anxiety in postcoronary artery bypass grafting encephalopathy: a case report

Frank M Dattilio¹, John E Castaldo²

¹Harvard Medical School, Boston, MA, USA; ²Penn State University Medical School, Lehigh Valley Hospital, Allentown, PA, USA

Abstract: Post-coronary artery bypass grafting encephalopathy (CABGE) is associated with cognitive decline in a significant number of post-cardiac surgery cases. Patients may experience this condition as a result of being maintained on a heart-lung machine, which is referred to as the “pump”. The pump is used to circulate oxygenated blood during heart or valve surgery and may contribute to complication with oxygen flow to the brain. In some cases, the emotional traumatic effects of CABGE may produce symptoms of anxiety that can often mimic the cognitive decline associated with cardiac bypass and use of the pump. When this is the case, cognitive–behavioral assessment may be useful in helping patients to differentiate symptoms generated by anxiety from those produced by the effects of the pump. A discussion section addresses further implications of such overlapping symptoms and therapeutic strategies for treatment and remediation, along with the potential adverse effects that may occur through psychotherapy.

Keywords: coronary artery bypass grafting, pumphead, cognitive impairment, encephalopathy