“Patients with a repeat heart attack were more likely to know the symptoms than first-time sufferers, but recognition was low in both groups,” said study author Dr. Kyehwan Kim of Gyeongsang National University Hospital, Jinju, Republic of Korea. “Most patients could identify chest pain but less than one-third knew the other symptoms.”
This study was designed to investigate the associations between the recognition of symptoms, time to treatment, and clinical outcomes. The researchers utilized data from KRAMI-RCC (2) which is a registry of myocardial infarction patients that were asked if they recognized the following symptoms: chest pain, shortness of breath, cold sweats, radiating pain (to the jaw, shoulder, or arm), dizziness/vertigo/lightheadedness/loss of consciousness, and stomachache. Patients were classified as recognizing symptoms if they could identify at least one symptom, or as did not recognize symptoms.
11,894 myocardial infarction patients were included in this study, 10,623 were first-time events and 1,136 were repeat events of which 118 were excluded for one reason or another. The researchers report that 52.3% of the patients recognized at least some of the symptoms of myocardial infarction, 92.9% identified chest pain, 32.1% identified shortness of breath, 31.4% identified cold seats, 27.4% identified radiating pain, 7.5% identified dizziness/loss of consciousness, and 1.3% identified stomachache as being possible symptoms of myocardial infarction.
57.4% of the patients who identified symptoms of myocardial infarction received treatment to open the arteries and restore blood flow within two hours, compared to 47.2% of those who did not recognize any of the symptoms. Additionally, those who recognized symptoms had a lower in-hospital mortality rate, and those who could not recognize symptoms often had more cardiogenic shock as well as heart failure.
Only 14.4% of those with first-time myocardial events could identify symptoms. Among those with repeat events, 57.5% of the patients previously enrolled in KRAMI-RCC were able to recognize symptoms compared to 43.2% for those previously not enrolled.
Dr. Kim said: “The findings indicate that education is needed for the general public and heart attack survivors on the symptoms that should trigger calling an ambulance. In our study, patients who knew the symptoms of a heart attack were more likely to receive treatment quickly and subsequently survive. Women, older patients, those with a low level of education, and people living alone may particularly benefit from learning the symptoms to look out for.”
