title: Stress-induced heart symptoms and perceptual biases in patients with congenital heart disease.
abstract: BACKGROUND
  The aim of the present study is to clarify whether biased symptom perception towards heart symptoms may explain a reduced quality of life in patients with congenital heart disease (ConHD). The present study tested the hypothesis that the combination of ConHD and high trait anxiety increases the perception of heart symptoms during acute stress.
  
  
  METHODS
  25 patients and 24 healthy participants completed a stressful computer task. Participant's heart and non-heart symptoms were measured after stress and after relaxation. Heart rate, blood pressure, respiratory rate, and arterial partial pressure of CO2 were monitored continuously.
  
  
  RESULTS
  In line with the prediction, a combination of high trait anxiety and ConHD resulted in an increased perception of specifically heart symptoms during stress. Moreover, the increased perception of heart symptoms could not be explained by acute heart dysfunction.
  
  
  CONCLUSIONS
  Heart dysfunction is not the only cause of an increased perception of heart symptoms. A history of disease experience in combination with high trait anxiety may increase the perception of heart symptoms during stress and may eventually result in an increased risk of developing a reduced quality of life.
authors.affiliation: Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. P.Karsdorp@DMKEP.unimaas.nl
authors.forename: Petra A
authors.initials: PA
authors.lastname: Karsdorp
authors.forename: Merel
authors.initials: M
authors.lastname: Kindt
authors.forename: Simon
authors.initials: S
authors.lastname: Rietveld
authors.forename: Walter
authors.initials: W
authors.lastname: Everaerd
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
mesh_terms: D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D010465:Perception; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology*