By Lyndsay Moss
OVER 40% of heart attacks may be going undiagnosed at the time they occur, research suggested yesterday.
A Dutch team assessed more than 4,000 men and women over the age of 55 to see if any had suffered a heart attack which went undiagnosed when it happened.
They estimated that 43% of heart attacks had been clinically unrecognised.
Men were more likely to get a diagnosis straight after an attack than women, according to the study.
The findings suggested the role of electrocardiograms (ECG) in current health programmes to prevent further heart trouble should be evaluated.
The team enrolled 5,148 people with no evidence of having had a myocardial infarction (MI) - a heart attack - from 1990 to 1993, with each having a baseline ECG and examination.
Information from formally diagnosed MIs were analysed, with an average of six years follow-up.
The researchers found that 4,187 people went on to have at least one more ECG and these were analysed to see if they had at some point suffered a heart attack that was not diagnosed at the time it happened.
Lead researcher Dr Jacqueline Witteman said: "Overall, 43% of the total heart attacks had been clinically unrecognised - a third of the male heart attacks and more than a half of the female heart attacks".
Co-author Dr Eric Boersma said there were several factors likely to help explain why heart attacks could go unrecognised.
"Men and women experience chest pain in different ways. MIs can occur without typical symptoms in women, also in people with diabetes and the elderly.
"They may sense shoulder pain instead of chest pain, they may think they have severe flu that is taking a long time to recover from, and those with an inferior-wall infarction may complain of stomach pain.
"It is also a problem that women and their doctors have traditionally worried more about death from breast and gynaecological cancer, than from heart disease."
The researchers suggested that ECG could be used as part of preventative health programmes to reduce the risk of repeated heart problems.
Those people who have a recognised heart problem can be given drugs such as aspirin and statins to reduce the danger to their health.