Public recognition of major signs and symptoms of heart attack: seventeen states and the US Virgin Islands, 2001

doi:10.1016/j.ahj.2003.12.036

American Heart Journal

Volume 147, Issue 6, June 2004, Pages 1010-1016

https://doi.org/10.1016/j.ahj.2003.12.036 Get rights and content

Abstract

Background

Timely access to emergency cardiac care and survival is partly dependent on early recognition of heart attack symptoms and immediate action by calling emergency services. We assessed public recognition of major heart attack symptoms and knowledge to call 9-1-1 for an acute event.

Methods

Data are from the 2001 Behavioral Risk Factor Surveillance System, a state-based telephone survey. Participants (n = 61,018) in 17 states and the U.S. Virgin Islands indicated whether the following were heart attack symptoms: pain or discomfort in the jaw, neck, back; feeling weak, lightheaded, faint; chest pain or discomfort; sudden trouble seeing in 1 or both eyes (false symptom); pain or discomfort in the arms or shoulder; shortness of breath. Participants also indicated their first action if someone was having a heart attack.

Results

Most persons (95%) recognized chest pain as a heart attack symptom. However, only 11% correctly classified all symptoms and knew to call 9-1-1 when someone was having a heart attack. Symptom recognition and the need to call 9-1-1 was lower among men than women, persons of various ethnic groups than whites, younger and older persons than middle-aged persons, and persons with less education. Persons with high blood pressure, high cholesterol, diabetes mellitus, or prior heart attack or stroke were not appreciably more likely to recognize heart attack symptoms than were persons without these conditions.

Conclusions

Public health efforts are needed to increase recognition of the major heart attack symptoms in both the general public and groups at high risk for an acute event.

Section snippets

Methods

The Behavioral Risk Factor Surveillance System is a state-based random digit-dialed telephone survey conducted by state health departments in collaboration with the Centers for Disease Control and Prevention.⁸ Samples represent each state's civilian, noninstitutionalized, adult population aged ≥18 years. The survey includes core questions asked of all participants every year or every other year and modules on specific public health topics. In 2001, 17 states and the US Virgin Islands included

Results

Sample characteristics are shown in Table I. Most participants (95%) recognized chest pain or discomfort as a heart attack symptom (Table II). Most participants also identified pain or discomfort in the arm or shoulder (89%) and shortness of breath (87%) as heart attack symptoms. Fewer participants indicated that pain in the jaw, neck, or back (51%) or that feeling weak, light-headed, or faint (65%) were symptoms. However, approximately one third of participants also incorrectly classified

Discussion

Definitive treatment for heart attack is early revascularization with either angioplasty or thrombolytic therapy.10, 11 Patient outcomes are improved with either therapy when initiated as soon as possible. Heart attack symptom recognition is logically tied to taking action to receive prompt emergency care. Although most persons recognized chest pain as a heart attack symptom, results from the National Registry of Myocardial Infarction suggest that 33% of patients admitted to a hospital with a

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Clinical investigations: acute ischemic heart diseasePublic recognition of major signs and symptoms of heart attack: seventeen states and the US Virgin Islands, 2001

Abstract

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Soc Sci Med

Patient Educ Counseling

Am J Cardiol

Ann Emerg Med

Prehosp Emerg Care

Am J Cardiol

Heart Lung

Am J Cardiol

Am Heart J

Patient Educ Counseling

2002 heart and stroke statistical update

Sudden cardiac death in the United States, 1989 to 1998

Circulation

State-specific mortality from sudden cardiac death—United States, 1999

MMWR Morb Mortal Wkly Rep

Healthy people 2010 (conference edition, in 2 volumes)

Warning signs of a heart attack

Circulation

State-specific prevalence of selected chronic disease-related characteristics—Behavioral Risk Factor Surveillance System, 2001

MMWR Surveill Summ

SUDAAN user's manual, release 7.0

Clinical investigations: acute ischemic heart disease
Public recognition of major signs and symptoms of heart attack: seventeen states and the US Virgin Islands, 2001