Schwarz Julio, Prashad Adesh, Winchester David E
From the * Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL; and † University of Florida, Gainesville, FL.
Crit Pathw Cardiol. 2015 Mar;14(1):44-7. doi: 10.1097/HPC.0000000000000038.
Anxiety is a common condition which can manifest with symptoms of chest discomfort. Chest discomfort is one of the most common reasons to seek emergency medical care. We hypothesize that anxiety is highly prevalent, poorly diagnosed, and poorly treated in an acute care environment. We analyzed data from a prospective registry of chest pain patients with low to intermediate likelihood of acute coronary syndrome and coronary artery disease. Scores from the General Anxiety Disorder-7 questionnaire determined the prevalence of anxiety. Differences in presentation, evaluation, and 30-day outcomes were compared for subjects with and without severe anxiety. Of the 151 included subjects, severe anxiety was observed in 15%, moderate 14%, mild 30%, and 41% had no anxiety symptoms. Subjects with severe anxiety had similar baseline characteristics, cardiac risk factors, and symptoms to those without severe anxiety, except for the current use of tobacco (50.0% vs. 18.6%; P = 0.001). Anxiety was self-reported by 54.5% of subjects with severe anxiety and 27.3% were on antianxiety medications. Hospital admission (P = 0.888) and repeated emergency department visits within 30 days (P = 0.554) were not different between the 2 groups. Anxiety is common among patients seeking emergency evaluation of chest pain. Half of patients with severe anxiety were diagnosed and roughly one quarter were medically treated. Cardiac risk factors and symptoms are not different for patients with severe anxiety; these patients warrant a similar evaluation for heart disease as those patients without anxiety.
焦虑是一种常见病症，可表现为胸部不适症状。胸部不适是寻求紧急医疗护理的最常见原因之一。我们推测，在急性护理环境中，焦虑症极为普遍，诊断不足且治疗不力。我们分析了来自急性冠状动脉综合征和冠状动脉疾病可能性低至中等的胸痛患者前瞻性登记处的数据。通过广泛性焦虑障碍-7问卷得分确定焦虑症的患病率。比较了有严重焦虑和无严重焦虑受试者在临床表现、评估及30天预后方面的差异。在纳入的151名受试者中，观察到15%有严重焦虑，14%有中度焦虑，30%有轻度焦虑，41%无焦虑症状。有严重焦虑的受试者与无严重焦虑的受试者具有相似的基线特征、心脏危险因素和症状，但当前吸烟情况除外（50.0%对18.6%；P = 0.001）。54.5%有严重焦虑的受试者自述有焦虑，27.3%正在服用抗焦虑药物。两组之间的住院率（P = 0.888）和30天内重复就诊急诊科情况（P = 0.554）无差异。在寻求胸痛紧急评估的患者中焦虑症很常见。严重焦虑患者中有一半得到诊断，约四分之一接受了药物治疗。严重焦虑患者的心脏危险因素和症状并无差异；这些患者与无焦虑患者一样，都需要对心脏病进行类似的评估。
