According to The Los Angeles Times heart disease and depression often go together, for reasons that physicians don’t really understand. So it would seem an especially bitter pill that patients with depression who are suffering from heart attacks get slower care at emergency rooms.
Such is the finding from a paper just published in the Canadian Medical Assn. journal, known as CMAJ. The authors suggest this could be one reason among a number why depressed patients with heart disease have poorer medical outcomes than people with heart disease but no depression. (There are lots of others, such as the fact that people who are depressed are less likely to change their lifestyle in ways that would help their heart.)
The scientists looked at 6,784 patients visiting Ontario, Canada ERs in 2004 and 2005, all for what turned out to be heart attacks. Of those, 680 had a history of depression.
Of the depressed group, 39% were given a low-priority assignment after triage at the ER; that compares with 32.7% for those without a history of depression. The most likely explanation, the authors say, is that patients with a history of depression were more likely to be diagnosed as having some kind of anxiety attack or feelings that were psychosomatic. After all, symptoms such as chest pain and shortness of breath go along with both conditions.
There is little surprise that depression is one of the conditions that Dr. O’Toole questions patients about. It is important to include it as part of the patients medical history. Patients considering procedures like breast augmentation tend to be very concerned with the anticipated result of their surgery. Some feel that they will be too large, others fear that they will be too small. It is important that as the patients choose their breast augmentation size that they are in good mental condition so that they are confident in their choice. For most patients breast augmentation is a very positive experience.
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