A patient with LVAD reports pervasive sadness and low motivation for weeks after surgery. Which complication?

• A. Stroke
• B. RH failure
• C. Depression
• D. Device failure/death

Answer: (C)

Persistent sadness and lack of motivation occurring weeks after LVAD implantation signal a depressive mood disorder, a recognized complication in LVAD patients. This mood pattern is different from acute device or organ problems. A stroke would typically show focal neurological signs such as weakness on one side, speech or vision changes. Right heart failure would present with signs of venous congestion—leg or abdominal swelling, ascites, hepatomegaly—and fatigue from poor forward flow. Device failure or death would present with device alarms, loss of pump function, dizziness, or sudden clinical deterioration, not isolated mood symptoms. Depression in this setting can stem from the psychological burden of living with an LVAD, lifestyle changes, and ongoing health anxieties, and it requires timely mental health assessment and a multidisciplinary management plan, including psychosocial support and, when appropriate, pharmacologic therapy.