Patients who visit an emergency department with a heart attack may receive delayed treatment if they've had depression. In one study, Canadian researchers pointed to past research that found that patients do more poorly after a heart attack if they have depression. They looked at 6,784 patients who were admitted to 96 Ontario hospitals with a heart attack to see if those with a history of depression were more likely to be considered lower priority when they arrived in the emergency department.

Of those patients, 10 percent of patients had a history of depression. In all, 39 percent were given a low-priority score, compared with just 33 percent of people without a history of depression. Patients with depression were also about three minutes slower to receive an electrocardiogram (a test to check out their heart rhythm) and more than two hours slower to receive percutaneous coronary intervention (a treatment to open up the heart’s blood vessels using a balloon inflated through a catheter).

One possibility is that emergency department staff assume that in people with depression, their chest pain or other possible heart attack symptoms may be due to depression or anxiety rather than lack of blood flow to the heart. Further studies are needed to understand all the factors contributing to this delay.

Source: CMAJ: Canadian Medical Association Journal, Volume 183, page 663; April 5, 2011

Publication Review By: Karen L. Swartz, M.D.

Published: 21 Aug 2013

Last Modified: 21 Aug 2013