Additional cardiac testing vital for patients with anxiety and depression

November 11, 2010, Concordia University

People affected by anxiety and depression should receive an additional cardiac test when undergoing diagnosis for potential heart problems, according to a new study from Concordia University, the Université du Quebec a Montreal and the Montreal Heart Institute.

As part of this study, published in the Journal of Cardiopulmonary Rehabilitation and Prevention, a large sample of patients received a traditional electrocardiogram (ECG), where they were connected to electrodes as they exercised on a treadmill. Patients also received a more complex tomography imaging test, which required the injection of a radioactive dye into the bloodstream followed by a nuclear scan to assess whether blood flow to the heart was normal during exercise.

"An ECG is usually reliable for most people, but our study found that people with a history of cardiac illness and affected by anxiety or depression may be falling under the radar," says study co-author Simon Bacon, a professor in the Concordia Department of Exercise Science and a researcher at the Montreal Heart Institute. "Although it is a more costly test, undergoing an additional nuclear scan seems to be more effective at identifying heart disease."

The discovery is significant, because 20 percent of people with cardiac illness also suffer from anxiety or depression. "When prescribing and performing cardiac tests, doctors should be aware of the psychological status of their patients, since it may affect the accuracy of ECG test alone," warns senior researcher Kim Lavoie, a psychology professor at the Université du Québec à Montréal and a researcher at the Montreal Heart Institute.

"ECG tests are not detecting as many heart problems as nuclear tests among many of these patients, particularly those that are depressed, and physicians may be under diagnosing people at risk," adds Professor Lavoie.

Some 2,271 people took part in the study and about half of participants had previously suffered from major heart attacks, bypass surgery or angioplasty. The other half were people exposed to heart disease because of high cholesterol levels, high blood pressure or other risk factors.

The study found that patients with anxiety disorders were younger and more likely to be smokers than patients without anxiety disorders. Participants with anxiety disorders were also less likely to be taking Aspirin or lipid-lowering medication, which can protect against some cardiac events. What's more, 44 percent of participants with anxiety disorders were found to also suffer from major depressive disorders.

"Patients with higher depression scores reported higher fatigue and exertion levels – effects that may be attributed to ," says Professor Lavoie.

To ensure heart disease doesn't go undetected, physicians should consider administering a brief questionnaire before conducting ECGs to determine whether patients are highly anxious or depressed. If so, their exercise performance should be carefully monitored. In the event of a negative (i.e., normal) ECG result, doctors may want to refer patients for nuclear testing.

"Our study indicates that detection of heart irregularities during ECGs may be influenced by the presence of mood or ," concludes lead investigator Roxanne Pelletier of the Université du Québec à Montréal and Montreal Institute. "Greater efforts should be made to include routine mood or disorder screening as part of exercise stress-testing protocols."

More information: Journal of Cardiopulmonary Rehabilitation and Prevention study: journals.lww.com/jcrjournal/Ab … ssment_of.99936.aspx

Related Stories

Recommended for you

Women run faster after taking newly developed supplement, study finds

January 19, 2018
A new study found that women who took a specially prepared blend of minerals and nutrients for a month saw their 3-mile run times drop by almost a minute.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.