Introduction: Anxiety and depression are the two most common mental disorders among medically ill patients with prevalence of 10%-50%. Anxiety and depression are prevalent in patient with heart disease and are associated with high morbidity and mortality. This study aims to determine the prevalence of anxiety and depression and its correlation with clinical profile in heart failure patients using the Hospital Anxiety and Depression Scale Filipino Version (HADS-P). Methods: A prospective cross-sectional study was conducted. HADS-P questionnaire was administered to heart failure patients admitted at the University of Santo Tomas Hospital from December 2013 to November 2014. After securing consent from the attending physicians and patients, the HADS-P questionnaires were then administered to the patients at the end of hospitalization by the investigator/s. The recommended cut-off score for HADS-P is score of 11. Chi-square and Independent T-tests were used in this study. Results: 144 heart failure patients were enrolled in this study. The prevalence of depression and anxiety among heart failure patients is 13.2% and 25.7%, respectively. Having prior coronary angiography, coronary angioplasty, EF < 40%, and multiple co-morbidity diseases/s are significant factors for depression. While among patients with anxiety, the significant factor is the length of hospital stay. Conclusion This study shows that depression and anxiety are common among heart failure patients. Heart failure patients should be screened for depression and anxiety especially among those having above mentioned clinical profile. The HADS-P questionnaire is an easily applied screening method. A formal psychiatric referral can be taken and should be a part of the comprehensive management among heart failure patients with depression and anxiety.
Anxiety ; Depression ; Heart Failure ; Heart Diseases

Background & Objectives: Stroke mimics are conditions that simulate the signs and symptoms of a stroke. These conditions pose a clinical challenge as they need to be distinguished from actual strokes based on neurologic findings, laboratory tests, and imaging studies in order to minimize the adverse effects of acute stroke therapies as well as hospital costs. The study aims to determine the rate and the most common etiologies of stroke mimics in a private tertiary care hospital in the Philippines and calculate the average cost incurred for diagnostics. Methods: We conducted a retrospective review of medical records of adult patients assessed by the hospital’s Brain Attack Team from 1 January 2014 to 31 December 2017. The diagnosis of stroke mimic was based on negative neuroimaging findings and laboratory results that showed an alternate diagnosis, in consultation with the stroke neurologist on call. Results: A total of 1,485 patient records were analyzed; 448 patients (30.2%) were diagnosed as stroke mimics. The most common etiologies were encephalopathy (83 cases, 18.5%), seizures (77 cases, 17.2%), headache (31 cases, 6.9%), hypertensive emergency (31 cases, 6.9%), and radiculopathy (27 cases, 6.0%). The average cost for diagnostics for each patient diagnosed as a stroke mimic was PHP 24,629.53 (approximately US$500). Conclusion: Stroke mimics are often encountered in the emergency setting. Due to the wide range of medical conditions that mimic stroke, early recognition is important in order to avoid the potential adverse effects of acute stroke therapies and minimize diagnostic costs, particularly in countries with limited resources.