A patient with LVAD reports chronic low mood, sleep disturbance, and reduced interest in activities. Which complication?

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

Answer: (C)

Depression is the best fit here. LVAD patients live with a complex device and lifestyle changes, which can lead to chronic low mood, sleep problems, and loss of interest—classic depressive symptoms. Depression in this population is a real complication that can affect quality of life and adherence to device care, medications, and follow-up, potentially influencing outcomes.

If this were a stroke, you’d expect sudden neurological changes—arm or facial weakness, speech difficulty, or sudden numbness—not a gradual mood change. Right-heart failure would present with symptoms of systemic congestion like leg edema, ascites, abdominal discomfort, or hepatomegaly, not persistent mood disturbances. Device failure or death would show device alarms, reduced flow, chest pain, or abrupt hemodynamic collapse, not evolving mood symptoms.

Screening tools like PHQ-9 can help identify depression, and management typically involves a combination of psychosocial support, psychotherapy, and careful consideration of pharmacologic therapy, all while coordinating with the LVAD team to ensure the patient’s device and medical needs are addressed.