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Seriously Ill Patients Have Limited Facial Expression

In the emergency room setting, facial expressions may help in assessment of cardiopulmonary disease

FRIDAY, July 18, 2014 (HealthDay News) -- Decreased variability of facial expression may help identify patients with serious cardiopulmonary disease in the emergency care setting, according to research published online July 14 in the Emergency Medicine Journal.

Jeffrey A. Kline, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues conducted a prospective study of diagnostic accuracy using a convenience sample of 50 adult patients presenting with dyspnea and chest pain in an emergency department. Facial expressions, including smile, surprise, and frown, were scored in response to emotional cues (stimulus slides). The diagnosis of cardiopulmonary disease, including acute coronary syndrome, pulmonary embolism, pneumonia, aortic or esophageal disasters, or new cancer, within the next 14 days was assessed.

The researchers found that, during the first stimulus slide, the median of all Facial Action Coding System values was significantly lower for disease-positive patients (3.4; first to third quartiles, 1 to 6) than for disease-negative patients (7; first to third quartiles, 3 to 14; P = 0.019). The largest difference between disease-positive and disease-negative patients was observed for the expression of surprise.

"With a single visual stimulus, patients with serious cardiopulmonary diseases lacked facial expression variability and surprise affect," the authors write.

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