Influence of visual objects and music on anxiety levels and imaging process in patients undergoing coronary CT angiography

OBJECTIVE: High anxiety during coronary computed tomography angiography (CCTA) can compromise imaging quality, increase radiation exposure, and elevate medication use. Therefore, optimizing waiting room environments to reduce patient anxiety is important for clinical outcomes. This study examines the effects of music and visual stimuli in the waiting rooms on patients' anxiety levels, heart rate, radiation dose, and beta-blocker use prior to CCTA. METHODS: This study, designed as a prospective and randomized trial, was conducted between April 15 and August 15, 2024, with 216 patients randomized into two groups: a standard waiting room (SWR) and a designed waiting room (DWR) featuring music and visual objects. Anxiety and depression levels were measured using the Hospital Anxiety and Depression Scale (HADS) and the State-Trait Anxiety Inventory (STAI). Additional parameters, such as heart rate, radiation dose, and beta-blocker requirement, were also recorded. RESULTS: In the DWR group, anxiety scores and heart rates were significantly lower compared to the SWR group (p < 0.001). Additionally, a notable reduction in radiation dose and beta-blocker use was observed in the DWR group (p < 0.05). In the general patient population, higher anxiety scores were associated with poorer imaging quality. Imaging quality was significantly better in the DWR group (p < 0.001). CONCLUSION: It has been demonstrated that waiting room designs enriched with music and visual stimuli reduce anxiety during CCTA scanning, enhancing patient comfort, improving imaging quality, and enabling imaging with lower radiation doses. The design of such waiting rooms can improve patient experience while optimizing outcomes. KEY POINTS: Question Can a waiting room with music and visual stimuli reduce anxiety and heart rate in CCTA patients, improving imaging quality and reducing beta-blocker use? Findings Music and visual stimuli reduced anxiety and heart rate, lowering beta-blocker use and radiation doses while improving imaging quality in CCTA. Clinical relevance Integrating music and visual stimuli in waiting rooms helps reduce anxiety and heart rate, leading to less medication use and radiation exposure while enhancing imaging quality. This simple, cost-effective approach improves patient comfort and optimizes outcomes in CCTA procedures.