Patient drawings important diagnostic tool for heart attack recovery

Simple drawings by heart attack victims of what they believe has happened to their heart may be an important diagnostic tool to aid their recovery, research at The University of Auckland has shown.

The study, carried out by researchers at the Faculty of Medical and Health Sciences, shows that patient drawings can give a better prediction of their long-term recovery than medical diagnosis of the damage.

PhD student Elizabeth Broadbent, who led the study, says the drawings are important because a patient’s own ideas about what has happened to their heart seem to strongly influence their recovery and return to normal activities.

“It seems that by asking a patient to draw what they think has happened, we may be able to quickly identify and correct any misconceptions they have about their illness and recovery.

“A heart attack victim’s early ideas about their illness seems to set the trajectory for their recovery. Patients who believe their condition will have a major influence on their life are slower to recover and return to normal activities than those patients who believe their illness is more controllable. And from our study it seems that pictures are a very good way of identifying these feelings.”

In the study 74 patients who had been hospitalised with acute heart attacks were asked to fill in a questionnaire and draw pictures of what they believe had happened to their hearts just before discharge.

The researchers also recorded their levels of a key heart enzyme which indicates how much heart muscle has been damaged in a heart attack.

A follow-up three months later showed that those who had drawn damage on their hearts were slower to return to normal activities, seemed to feel less in control over their recovery and were more distressed about their condition.

They also found that the amount of damage a participant drew on their heart gave a better indication of their return to normal activities than enzyme levels, which recorded actual damage.

In the past patient’s perceptions have been measured by either an interview or a questionnaire, but these have not always been able to identify what patients believe has actually happened to their heart, Elizabeth Broadbent says.

“Often patients are not asked about their own ideas about what has happened, yet these seem to play a major role in their recovery.”

Previous research has shown that a brief hospital-based psychological intervention after a heart attack can successfully change illness perceptions and improve recovery.

“Drawings are quick and easy for a patient to do. The heart seems to be easily visualised and although many of the drawings in our study were simple outlines they seem to be an accurate reflection of a patient’s perceptions of their illness.”