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Patients who arrive with depression as well as a heart attack will probably be low on the priority list in the emergency ward, researchers say.

In a brand new study, heart attack patients with a history of depression were significantly more likely than other patients to get a low triage score, based on Dr. Clare Atzema and her colleagues at the Institute for Clinical Evaluative Sciences in Toronto.

In addition they faced significant delays in diagnostic testing and authoritative care, Dr. Atzema and coworkers reported online in CMAJ.

The researchers speculated the observations may be explained by means of a tendency of ER staff to impute heart attack symptoms in patients with depression to somatization of the depression, rather than ischemia or to stress.

Spotting the Indications of Depression

Really, most patients who come to the emergency department with heart attack symptoms, like chest pain or shortness of breath, are not having one — so staff are actively looking for other possible causes of the symptoms, the researchers noted.

Dr. Atzema and colleagues noted that several studies have demonstrated that patients with heart attack do worse if they also have depression, but added that the job of ER attention in those results has apparently not been analyzed.

To help fill the gap, they looked at records of 6,874 patients treated for heart attack over a one-year interval at 82 hospital corporations in Ontario, Canada’s the state.! of most

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They found that 10 percent of the heart attack patients nearly 40 percent of those patients were given a low triage score, in contrast to about 33 percent of the rest of the patients, and there had a history of melancholy — a significant difference.

For patients who had a history of melancholy on their graphs, the researchers found a 26 percent higher danger of finding a triage score that was low. On the other hand, there was no increased risk of getting a low score for patients with asthma or COPD.

New Laws May Change Depression Treatment

The researchers cautioned that they failed to validate with an external source the analysis of melancholy which was about the patient’s ER chart. Also, they said it’s not impossible that in some instances the diagnosis was missed at triage and added after by the attending physician.

“We suspect that mistriage of these (depressed) patients isn’t due to purposeful discrimination by emergency department staff, but rather that most emergency department staff are unaware of data that suggests a link between depression and coronary artery disease,” they asserted.

The study had support from the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, as well as the Institute for Clinical Evaluative Sciences. No possible conflicts were reported by the researchers.

Find out more in our Depression Facility.

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