Cognitive and physical fatigue-the experience and consequences of 'brain fog' after spontaneous coronary artery dissection: a qualitative study.

Abstract

Aims: Brain fog and fatigue are common issues after acute coronary syndrome. However, little is known about the nature and impact of these experiences in spontaneous coronary artery dissection (SCAD) survivors. The aim of this study was to understand the experiences of brain fog and the coping strategies used after SCAD.

Methods and results: Participants were recruited from the Victor Chang Cardiac Research Institute Genetics Study database and considered eligible if their event occurred within 12 months. Seven semi-structured online focus groups were conducted between December and January 2021-22, with this study reporting findings related to brain fog and fatigue. Interviews were transcribed and thematically analysed using an iterative approach. Participants (n = 30) had a mean age of 52.2 (±9.5) and were mostly female (n = 27, 90%). The overarching theme of brain fog after SCAD included four main themes: how brain fog is experienced, perceived causes, impacts, and how people cope. Experiences included memory lapses, difficulty concentrating and impaired judgement, and perceived causes, including medication, fatigue and tiredness, and menopause and hormonal changes. Impacts of brain fog included rumination, changes in self-perception, disruption to hobbies/pastimes, and limitations at work. Coping mechanisms included setting reminders and expectations, being one's own advocate, lifestyle and self-determined medication adjustments, and support from peers.

Conclusion: Brain fog is experienced by SCAD survivors, and the impacts are varied and numerous, including the capacity to work. Spontaneous coronary artery dissection survivors reported difficulty understanding causes and found their own path to coping. Recommendations for clinicians are provided.