Irish researchers have found, however, that two-thirds of patients experience heart attack symptoms that are not so dramatic, and so delay vital, emergency treatment.
More often, heart attack symptoms are insidious and puzzling, such as unexplained fatigue or abdominal discomfort and most people wait for hours before getting help. Woman may also experience very different symptoms to men and so fail to recognise them as a heart attack.
Researchers at the School of Nursing and Midwifery at Trinity College Dublin looked at the type of symptoms experienced by almost 900 patients who suffered heart attacks, as well as the length of time it took them to attend five different hospitals.
The study, funded by the Health Research Board and published in The Journal of Emergency Medicine, found that people who experienced ‘slow-onset’ heart attack symptoms took on average one and a half hours longer to arrive at a hospital’s emergency department than those with ‘fast-onset’ symptoms.
A significant number of patients who experienced slow-onset symptoms first telephoned (44%) — or visited (42%) — their GP.
Only one-third of those with slow-onset symptoms travelled to hospital by ambulance, compared to half of those with fast-onset symptoms.
Delays in treatment of a heart attack can have a significant impact on a patient’s outcome, both in terms of mortality and potential damage to the heart muscle.
Director of undergraduate teaching and learning at the School of Nursing and Midwifery, Dr Sharon O’Donnell, said most people expected a heart attack to be associated with sudden, severe and continuous chest pain. She said the most surprising finding was that, for the majority of people in the study their heart attack started off with mild or intermittent symptoms, such as chest and left arm discomfort, shortness of breath and fatigue.
“Future educational campaigns must dispel the myth that heart attacks always occur in a dramatic fashion,” she said.
“If someone experiences any worrying symptoms which are unresolved with rest or usual cardiac medication, then they should call an ambulance and go to hospital immediately.”
Dr O’Donnell said clinicians also needed to be equally vigilant for the milder and slower onset of heart attack symptoms.