Comparison of the anxiety and depression levels of patients attending the emergency department with chest pain

Introduction and Purpose: Chest pain is one of the most common reasons for emergency department visits. While chest pain can have cardiac causes, it can also be caused by pulmonary, pleural, musculoskeletal, gastrointestinal, dermatological, and psychiatric reasons. Once life-threatening causes of chest pain have been ruled out, further investigation is conducted to explore other potential causes. In our study, we aimed to determine the levels of anxiety and depression in patients presenting to the emergency department with chest pain using the Hospital Anxiety and Depression Scale (HADS). Material and Method: Our study was a single-center prospective study and included 250 patients who presented to the emergency room with chest pain after receiving approval from the Necmettin Erbakan University Meram Faculty of Medicine Drug and Non-Medical Device Research Ethics Committee on September 16, 2022. The demographic data of the patients were recorded by the physician and the HAD scale consisting of 14 questions was applied to the patients. The data were analyzed using SPSS version 21.0 (Chicago, USA) software package. Results: 250 patients who presented to the emergency department with chest pain were included in the study. The mean age of the patients included in the study was 51.0 ± 17.0. Of the cases, 57.2% were male and 42.8% were female. The most commonly observed comorbid diseases were coronary artery disease (CAD), hypertension (HT), and diabetes mellitus (DM). The cardiac risk classification of the cases was performed according to the HEART score. Accordingly, the cardiac risk was low in 56.4%, moderate in 36.8%, and high in 6.8% of the cases. Significant differences were observed in HADS-A (p=0.015) and HADS-D (p=0.001) scores among cardiac risk groups according to the HEART score. In terms of anxiety disorder, 28.4% of patients in the low-risk group, 39.1% of the moderate-risk group, and 41.2% of the high-risk group were found to be at high risk. Similarly, 21.3% of patients in the low-risk group, 38% of the moderate-risk group, and 47.1% of the high-risk group were found to be at high risk for depression. Conclusion: After life-threatening causes of chest pain are ruled out in patients who present to the emergency room with chest pain, psychological causes such as anxiety disorders and depression should also be considered, especially in cases where there is no organic cause that causes recurrent visits.