Authors: Ren, Yanping; Yang, Hui; Browning, Colette; Thomas, Shane
A 47-year-old woman complained of sudden chest tightness, shortness of breath, palpitations and a severe headache. Her highest blood pressure had reached 200/120 mmHg before and was diagnosed as hypertension. One month ago, the results of her cranial CT scan showed multiple lacunar cerebral infarctions. She then complained of insomnia, extreme fatigue, poor appetite, loss of interest in everything and paid more attention to her blood pressure and measured blood pressure over five times per day at home. The patient went to visit a psychologist who drew the conclusion of depression. She took sertraline (50 mg once a day) and followed up with the psychologist in the following 2 weeks. During the last month, she has taken 30-mg nifedipine controlled-release tablets once a day and the blood pressure was well-controlled. More attention should be paid to the mental status of patients with cardiovascular disease. There are many screening tools to assess depression in cardiovascular disease patients. The ‘physical-mental’ treatment of cardiovascular disease cannot be conducted at one time and follow-ups are necessary.