Study Finds Heart Attack Symptoms -- Except Chest Pain -- Are Often Ignored

November 23, 1998

WINSTON-SALEM, N.C. -- While most people are aware that chest pain is a heart attack symptom, other heart attack symptoms are often ignored, according to results from a multi-center study published today (Nov. 23, 1998) in Archives of Internal Medicine, a publication of the American Medical Association.

These other symptoms include numbness or pain in the arm, shortness of breath, and sweating, nausea or vomiting, dizziness or lightheadedness and five others, according to the principal author, David C. Goff Jr., M.D., Ph.D., associate professor of public health sciences (epidemiology) at Wake Forest University School of Medicine.

The issue is critical because clotbusters -- drugs that can reverse a heart attack in progress -- only work for a limited time after a heart attack begins. Delay may mean permanent heart damage, or even death.

"Knowledge of chest pain as an important heart attack symptom is high and relatively uniform," said Goff. "However, knowledge of the complex constellation of heart attack symptoms is deficient in the U.S. population, especially in socioeconomically disadvantaged and race or ethnic minority groups."

Goff also said that even people who are at higher risk of heart attacks -- such as those with diabetes, high blood pressure, high cholesterol levels or who are currently smoking cigarettes -- "do not demonstrate greater knowledge of heart attack symptoms than lower-risk persons."

He said, "This disappointing finding supports the conclusion that health care professionals are not targeting these patients effectively for education about heart attack symptoms."

Goff said clinical trials had demonstrated that clot-busters work well when used within the first six hours after a heart attack begins, but their value diminishes rapidly after six hours. "Approximately 22 percent of heart attack patients delay seeking care for at least six hours following the onset of symptoms," Goff said.

The study, called REACT (for Rapid Early Action for Coronary Treatment) involved surveying 1,294 adults in 20 communities. The investigators found that regardless of age, race, education, or household income, nearly nine out of ten people knew chest pain is a heart attack symptom.

But knowledge of the next most common heart attack symptom, arm pain or numbness, varied widely. More than three-quarters of the middle and upper income people surveyed knew arm pain or numbness was a symptom, compared to just half of those with incomes under $25,000. Three-quarters of whites knew, compared to 47 percent of African-Americans and 51.7 percent of Hispanics.

Half of the people from virtually all demographic divisions recognized shortness of breath as a symptom, but recognition that unexplained profuse sweating was a heart attack symptoms varied widely, from 24.9 percent among whites to 12.3 percent among African-Americans and 10.6 percent among Hispanics. Nearly one-third of those with incomes over $55,000 recognized sweating as a symptom, compared to just 12.8 percent of those with incomes under $25,000.

Those people who had a personal history of heart disease, or previous experience with heart disease in the family or in a close friend or relative generally did better in recognition of heart attack symptoms -- but even they did not have complete knowledge.

Goff said that ways must be designed to teach the complex constellation of heart attack symptoms to minorities, lower income people and those who are at high risk.

He said that stories by role models based on the experiences of real heart attack victims may help in making these symptoms clear. Then, he said, people have to take this knowledge of heart attack symptoms and translate it into rapidly taking action when symptoms appear.

The goal: to increase the number and percentage of people with heart attacks who get to the hospital soon enough to benefit from clot-busting drugs and other treatments that only work well for a few hours after a heart attack begins.

The study was paid for by the National Heart Lung and Blood Institute.

Contact: Robert Conn, Jim Steele or Mark Wright at 336-716-4587

Wake Forest Baptist Medical Center

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to