In 2013 I had open-heart surgery for an atrial-septal defect. These are congenital and general the hole in the wall between the atria is very small. However mine seemed to get much larger over the years. No heart surgeon, ER doctor, or the lady who scheduled the surgeries believed me though because that "shouldn't happen" so it was deemed that it was "all in your head" and I got ignored and ignored until I didn't think I was going to live much longer. As I was waiting for surgery my husband contacted a psychiatrist in the US who was just finishing up research on the relationship between PTSD on major heart events. He actually sent us a copy of his journal article before it was published. My husband described my scenario and asked if ptsd could be affecting my heart in this way and the psychiatrist replied "absolutely!". Sadly, no doctors that I was dealing with were interested in the article and I only was able to have surgery because there was a cancellation that no body else wanted. Upon opening me up the surgeons and anesthetist were shocked at how huge the hole in my heart was. Suddenly it wasn't "all in your head". I hope more doctors become open to hearing about the very real, physical effects of PTSD.