Too Many Heart Attack Victims Don't Call 911
He and his colleagues are planning another survey that will ask patients
more specific questions about phone calls with their doctors.
The current study demonstrates that the public must be educated about when
and how to seek treatment, according to David A. Meyerson, MD, a cardiologist
at the Johns Hopkins Medical Institutions and a spokesman for the American
Heart Association (AHA). "The AHA would like people to understand that
there are perhaps 1.2 million heart attacks occurring in the U.S. each year,
and only 950,000 make it to the hospital. So 250,000 are dying before they get
[there]." The earlier you get treatment, the more likely you will avoid
damage, he says.
"People are embarrassed," Meyerson says. "They don't want to
come to the emergency room complaining of something and find it to be
indigestion. They're afraid they made the wrong decision. If the symptom[s] ...
look like it is cardiac-related, we should urge them to seek early
Prompt treatment also may make a dent in the in-hospital deaths. "We now
have the ability to turn off a heart attack in midstream with clot-dissolving
medications or angioplasty," which involves using a tiny balloon that is
inflated to flatten the clot in the clogged vessel. These treatments can
preserve heart muscle function, preventing heart failure and reducing deaths,
"Time is muscle," Meyerson says. "The longer you wait, the more
heart muscle dies."
Although the survey didn't ask people directly whether cost was a factor in
their decision to call 911, it was noted that in areas that had either
state-supported emergency medical services or a subscription service, the
service was used twice as often as in areas that didn't have it.
"Cost could be a part of it," says David E. Wilcox, MD, FACEP, a
spokesman for the American Academy of Emergency Medicine Physicians. He points
out that some managed care programs have denied coverage if it was later
learned that the person didn't have a serious problem.
To combat this, now at least 32 states have passed legislation to define
"emergency" based on a layperson's interpretation, and a federal bill
seeks to do the same. "If you have signs or symptoms that you interpret to
be a potential emergency, and you go to the ED to have it checked out, the
insurance company must pay for it," says Wilcox in an interview with WebMD.
Wilcox also is medical director of ConnectiCare and a practicing emergency room
physician at St. Francis Hospital in Hartford.
It's important to get the "prudent layperson" definition of
emergency through the federal legislature, says Wilcox, because under the
Employee Retirement and Income Security Act (ERISA), large companies that are
self-funded do not fall under state law. So even though 32 states have passed
the statute, big companies that account for about 40% of all employees in the
country don't fall under it, he says.
"If you have a service that is free to you, [cost] is not a roadblock to
using it," says Wilcox.
For more from WebMD, read how to recognize an emergency.