Nearly half of U.S. adults don't recognize some heart attack symptoms

(Reuters Health) - Nearly half of Americans might not realize they are having a heart attack because they are not familiar with some of the symptoms, a new study suggests.

In a nationally-representative survey, 47% of people didn’t recognize some heart attack symptoms and nearly 6% were not familiar with any, researchers reported in JAMA Network Open.

People were more likely to be unfamiliar with symptoms if they were Hispanic, born outside the U.S., had a low income level, were uninsured or had a lower educational level

The findings suggest millions of individuals in the U.S. “remain unaware of the most critical symptoms of a (heart attack) . . . and, therefore, are at high risk of adverse outcomes,” write the researchers, led by Dr. Khurram Nasir, chief of the division of cardiovascular prevention and wellness at the Houston Methodist DeBakey Heart & Vascular Center in Texas.

The findings highlight the need for education targeted at specific groups to improve their awareness of heart attack symptoms and of the importance of early emergency care, the study team concludes.

The researchers did not respond to a request for comments.

While fewer people are dying after being hospitalized for a heart attack, patients often delay seeking help after experiencing symptoms and a large number die before reaching the hospital, the researchers note in their report.

To explore why people might not be getting to the hospital soon enough, the researchers turned to responses to the 2017 National Health Interview Survey, focusing on data from 25,271 U.S. residents age 18 or older.

As part of the survey, participants were asked, “Which of the following would you say are the symptoms that someone may be having 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.”

Slightly more than half, 53%, correctly identified all five options as being symptoms of a heart attack, while 20% were not aware of the three most common symptoms and 5.8% were not aware of any of the symptoms.

Participants born outside the U.S. and those of Hispanic ethnicity were nearly twice as likely as others to be unfamiliar with any heart attack symptoms. Those with a lower educational level were 1.3 times more likely to not recognize any of the heart attack symptoms compared to those with a higher educational level.

Among participants who were black or Hispanic, and born outside the U.S., had a low income and low educational level, and no insurance, nearly one in five were unfamiliar with any heart attack symptoms. People with all these traits were six times more likely than others to be unfamiliar with any symptoms, the study found.

“This is a striking analysis,” said Dr. Jared W. Magnani, a cardiologist and associate professor at the University of Pittsburgh, in Pennsylvania.

Magnani has seen his share of patients who didn’t come to the emergency room at the first signs of a heart attack “because they didn’t recognize the symptoms.”

“People who delay can have increased heart damage and an increased risk of heart failure,” Magnani said.

The new study “is extremely important,” said Dr. Icilma Fergus, director of cardiovascular disparities at The Mount Sinai Hospital in New York City.

“The findings in the study are not surprising, but underscore the need for more targeted education for those people with language barriers, cultural differences and less access to good healthcare,” Fergus said in an email. “These are the very groups who suffer from cardiovascular disparities.”

The success of campaigns to get people to recognize stroke symptoms shows that community-focused programs can successfully raise awareness, Magnani said.

SOURCE: JAMA Network Open, online December 18, 2019.