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Sweating Prompts Heart Attack Care

Sweating May Be a Key Factor in Heart Attack Victims' Seeking of Treatment

WebMD Health News
Reviewed by Louise Chang, MD

Nov. 15, 2005 (Dallas) - Sweating appears to be the symptom that prompts more people suffering a heart attack to get to the hospital, researchers have discovered.

"Heart attack patients often deny symptoms, [thereby] delaying treatment, but those who sweat are more likely to seek treatment earlier," says Catherine Ryan, PhD, RN, project coordinator of medical-surgical nursing in the department of nursing at the University of Illinois at Chicago.

Delays in seeking treatment remain a serious problem in heart attack victims' seeking of treatment that can seriously affect the outcome, she told those attending the American Heart Association.

"The typical heart attack symptoms include chest pain, shoulder and arm pain, and neck and jaw discomfort."

Symptoms Often Ignored

But a study of 1,073 heart attack patients hospitalized for heart attack found that though many individuals ignored the usual symptoms of heart attack, if sweating occurred, patients were less likely to delay treatment.

"Bells should ring off if a person suddenly starts sweating profusely," Ryan tells WebMD. "They shouldn't think they have the flu. If they don't have a fever, then they should start to think about something else."

Chicago researchers studied how delays in seeking treatment may be related to 12 common symptoms in heart attack patients. After combining the symptoms in cluster groups, they found that five distinct symptom clusters emerged.

Previous studies on treatment delay examined single symptoms, while this study examined symptom clusters.

"All the symptoms were put in the same pot, like soup, but it tasted different," she says. "The symptoms just fell out into different groups."

And while most individuals assume that chest pain signals a heart attack, a full 16% of patients had no indication of chest pain, delaying a necessary trip to the hospital, says Ryan.

Patients with the shortest delays in seeking treatment had the most symptoms and were more likely to have chest and upper extremity pain, indigestion, nausea, shortness of breath, sweating, dizziness, weakness, and fatigue, she explains.

And those with the longest delays -- an average of almost 23 hours -- had the fewest symptoms.

Another group that delayed treatment an average of 21 hours had symptoms that were easily confused with gastrointestinal tract causes, she notes. This group was more likely to have symptoms such as chest and abdominal pain plus indigestion.

Women are more likely to experience back pain, jaw pain, shortness of breath, and nausea, vomiting, and fatigue, she says.

Sweating Is Red Alert for Many

But one of the key symptoms that got individuals to the hospital appeared to be sweating. The youngest group - mean age 60 - were the most likely to sweat and also had the shortest delay, arriving at the hospital in three hours.

"The youngest group was more likely to have sweating and had the shortest delay," she says. "The delay got longer as the probability of sweating was less prominent."

In fact, in some clusters sweating ranked higher than chest pain in getting patients to the hospital.

Though more study is needed, sweating may be a key symptom in prompting heart attack victims to seek treatment, Ryan says.

"It is important for people to recognize the symptoms of heart attack and act quickly," says Robert Bonow, MD, chief of cardiology at Northwestern Medical School in Chicago. "People need to recognize that symptoms of a heart attack are not only chest pain, but other symptoms can occur as well."

Sweating does occur, he says, due to activation of the symptomatic nervous system with a "fight or flight" response.

"There usually is a constellation of symptoms and people need to have an awareness of the symptoms," he says.

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