Residents whose range of facial expressions seems decreased may be cluing you in on a serious heart or lung problem, according to new research. The findings may prove helpful as more consultations are performed using telemedicine technology, the authors say.
Those with heart and lung conditions have particular difficulty registering surprise in response to emotional cues, finds preliminary research published online in Emergency Medicine Journal.
"We believe that due to the gravity of their illness, [these] patients may not have been able to process and respond to an emotional stimulus in the way that would be expected of most people under normal conditions," write the researchers.
The researchers tested the diagnostic accuracy of reduced facial expression range in 50 adults with shortness of breath and chest pain in an emergency department. The study participants briefly viewed three visual cues, designed to evoke an emotional response, on a laptop computer.
A computer webcam recorded their facial expressions in response to each of these cues—a humorous cartoon, a close-up of a surprised face and a picture of someone crying. The investigators analyzed these recordings for changes in facial muscle activity indicating smiling, frowning and surprise.
Study participants were checked for heart attack, unstable angina, lung blood clots, pneumonia, problems in the major artery or gut and new cancers. During the 14-day monitoring period that followed, eight (16 percent) of study participants developed serious heart or lung disease. Among the 42 (84 percent) considered not to have any serious health problems, chronic obstructive pulmonary disease worsened in two, heart failure developed in two and an irregular heart rhythm occurred in one.
The analysis of the webcam recordings showed that participants with chest pain and shortness of breath who had a potentially serious heart or lung condition had a significantly narrower range of facial expression in response to visual cues than those who did not have these health problems. The difference in the ability to express surprise most strongly demarcated those with serious heart and lung problems from those without them.
"The ultimate goal of this work is to provide clinicians with a new physical finding that can be associated with a healthy state to avoid unnecessary [computed tomography] scanning," which could be added to the physical examination, the authors say. As telemedicine consultations become more common, the ability to read someone’s face may become even more important, they add.