People born with serious heart defects go through a lot in life.

Starting at a young age, many heart patients endure multiple, risky surgeries. They suffer from fatigue and often have to sit out activities, such as neighborhood tackle football games. They tend to fall behind by missing school when heart problems and surgeries arise.

Now, new research shows they face another threat: As adults, people suffering from congenital heart disease have a greater risk than others of being diagnosed with post-traumatic stress disorder. Researchers at the Mayo Clinic report that people who have had heart failure or open-heart surgery at a younger age have a heightened risk of P-T-S-D. That includes flashbacks to their medical problems, obsessive thoughts about it, nightmares and extreme angst.

A study published recently in the American Journal of Cardiology showed that 21 percent of adults with congenital heart disease suffer from P-T-S-D. That’s nearly seven times the rate among the general population.

Doctors are just beginning to understand the long-term effects of congenital heart defects. That’s because treatments for such conditions have improved drastically and these patients now typically live well into adulthood. In the late 20th century, deaths from congenital heart defects dropped almost 40 percent.

The study authors say more research is needed to determine appropriate treatment, but one likely outcome is that psychological care becomes an important part of lifelong therapy for congenital heart disease patients. After all, even the bravest of us need help coping with life sometimes.