After LVAD implantation, the patient shows signs of anhedonia and lack of energy impacting daily life. Which complication?

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

Answer: (C)

After LVAD implantation, patients can face psychosocial challenges as they adjust to living with a continuous-flow device. Anhedonia and low energy that interfere with daily life are classic signs of depression, making it the most likely complication in this scenario. Depression in LVAD patients often emerges or worsens during recovery and adaptation to the device, and it can significantly impact functioning and outcomes.

This presentation doesn’t fit stroke, which would typically cause focal neurologic deficits such as weakness, speech trouble, or facial weakness, not just mood changes. It also doesn’t fit right heart failure, which would show signs of venous congestion like edema, ascites, or hepatomegaly rather than primarily mood or energy symptoms. Device failure or death would present with device alarms, sudden hemodynamic instability, or loss of device function, not a primarily depressive picture.

Thus, the signs described are best explained by depression, a common and important complication to identify and manage after LVAD implantation.