Psychological symptoms: a review of screening practices for patients with coronary heart disease (CHD)

Background/Aims: Coronary heart disease (CHD) and coronary events have been strongly linked to psychological symptoms in patients during hospitalisation and post-discharge. Within Australia CHD average length of stay is decreasing and symptoms often do not present until discharge. Early screening and treatment of psychological symptoms has been recommended to reduce mortality and identify anxiety and depression. This literature review was undertaken to evaluate and describe current screening practices to identify psychological symptoms in these patients.
Methods: A literature review of CINAHL; EBSCOhost; MEDLINE; ProQuest; Science Direct; Web of Science was conducted in research papers between the years 1999–2011. Key words included: Acute coronary syndromes (ACS); Anxiety; Cardiovascular disease (CVD); Coronary artery disease (CAD); Coronary events; Depression; Emotional distress; Percutaneous coronary intervention (PCI); Psychological symptoms and CHD; and Screening practices. Forty-five research papers were found.
Results: From the studies reviewed it was recommended that patients be assessed for psychological symptoms on presentation to hospital, whilst those with psychological symptoms are assessed for CVD. Some patients may experience psychological symptoms for up to one week to months post-cardiac event, whilst symptoms may not present until weeks post-discharge. Symptom severity is dependent on the physical event, personal characteristics and adjustment capabilities. Focus on treating the cardiovascular event may preclude the detection of psychological symptoms.
Conclusion: With a short hospitalisation, limited routine screening, and a focus on physical treatment after a coronary event, psychological symptoms may not be recognised and therefore treated. Routine early screening, along with timely referral for treatment and support is recommended for all CHD patients.