Heart attack patients with a history of depression may not get prompt medical attention when they show up at a hospital emergency room, a new study suggests.
The findings, published in the Canadian Medical Association Journal, are based on data from almost 7,000 patients admitted to 96 hospitals across Canada.
The lead researcher, Clare Atzema of the Institute for Clinical Evaluative Sciences in Toronto, noted that chest pain is one of the most common complaints at emergency rooms. Yet only a small percentage – about 10 per cent – of these cases involve real heart attacks.
Because of the high demand in an ER, a triage team tries to determine who is most in need of immediate care by asking patients a series of questions about their symptoms, medical past and prescription-drug use. When a history of depression is evident, there is sometimes a tendency for hospital staff to assume the patient’s symptoms are related to anxiety rather than due to a heart attack. As a result, the patient is less likely to receive high-priority care. An accurate diagnosis and treatment may be delayed, Dr. Atzema said.
“I don’t think this is purposeful discrimination,” she said. “They are just looking for a reason why it isn’t a heart attack because if we treated everyone who came to the emergency room as a heart attack, the entire system would collapse.”
Ironically, some medical studies have suggested that patients with a history of depression also face an elevated risk of heart disease. Dr. Atzema said emergency departments need to be made aware of this risk.
