Almost 50% of adults can't identify the five most common heart attack symptoms, putting them at higher risk for adverse outcomes such as heart damage and heart failure, according to a study published in JAMA Network Open.

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US adults don't know how to recognize a heart attack, study finds

Delayed treatment for a heart attack can increase the risk of heart damage and heart failure, according to cardiologist Jared Magnani, an associate professor at the University of Pittsburgh, who was not involved in the study. However, a large number of patients delay care after experiencing symptoms of a heart attack and many die before reaching the hospital, the researchers noted in their study.

To determine why heart attack patients don't seek care sooner, the researchers analyzed 25,271 U.S. adults' responses to the 2017 National Health Interview Survey.

The survey asked participants to determine which of the following might be symptoms of a heart attack: "(1) chest pain or discomfort; (2) shortness of breath; (3) pain or discomfort in arms or shoulders; (4) feeling weak, lightheaded, or faint; and (5) jaw, neck, or back pain."

About 53% of the participants correctly identified all five conditions as symptoms of a heart attack, meaning 47% didn't recognize at least one of the symptoms, the researchers said. 

According to the researchers, about 20% of respondents were unable to identify the three most common symptoms of a heart attack, which are chest pain or discomfort, shortness of breath, and pain or discomfort in the arms or shoulders. Another 5.8% of respondents didn't recognize any of the five common symptoms.

Familiarity with the heart attack symptoms varied by sociocultural factors, such as education and income level, the researchers found.

Among survey respondents with low income or low education levels, black or Hispanic respondents, respondents born outside the United States, and uninsured individuals, about one in five were unfamiliar with some of the symptoms.

How to address the information gap, according to researchers

The results indicate that many adults are "unaware of the most critical symptoms of a (heart attack)… and, therefore, are at high risk of adverse outcomes," the researchers wrote.

Magnani said the analysis was "striking," but perhaps not very surprising. Magnani noted that he has seen numerous heart attack patients who didn't come to the ED when they first noticed discomfort "because they didn't recognize the symptoms."

However, Icilma Fergus, director of cardiovascular disparities at The Mount Sinai Hospital who was not involved in the study, said while the findings may not be "surprising," they "underscore the need for more targeted education for those people with language barriers, cultural differences and less access to good health care." She added, "These are the very groups who suffer from cardiovascular disparities."

The researchers in the study wrote that "given that previous community interventions to improve awareness of symptoms and emergency medical service use in [myocardial infarction] have largely been unsuccessful," the demographic information from the survey "can help identify subgroups that are most in need of and may benefit from targeted public health awareness initiatives." 

The researchers behind the study did not respond to Reuters' request for comment (Carroll, Reuters, 12/18/19).