Heart Patients Get Failing Grade?

Study Shows Heart Patients Not Up to Speed on Symptoms and Risk

Medically Reviewed by Elizabeth Klodas, MD, FACC on May 28, 2008
From the WebMD Archives

May 28, 2008 -- If you were having a heart attack, would you know it? When it comes to recognizing the symptoms and getting the quickest care, many people fall short, according to a new study.

Researchers looked at 3,522 people who had survived a heart attack or had been treated for blocked arteries. Using a questionnaire, lead researcher Kathleen Dracup, DNSc, of the University of California, and colleagues around the world quizzed these patients about their knowledge of heart disease.

Heart Attack Knowledge

According to the survey:

  • 46% of respondents didn't do so well, answering less than 70% of the questions correctly.
  • Those with the highest scores were women, people younger than 60, people who were in cardiac rehabilitation, and those who were cared for by a cardiologist instead of an internist or general practitioner. Those who knew the least were older men with less formal education.
  • Women knew more about less common symptoms like back pain, jaw pain, heartburn, nausea, and neck pain.
  • Fewer men than women knew that heart disease was the most common killer of women.
  • More men said they would get someone to drive them to the hospital instead of going by ambulance. (Transportation by ambulance is recommended because care can begin right away.)

Study authors say the gender differences were "particularly surprising" because "women have often underestimated their risk for heart disease in years past and have longer pre-hospital delay times than men."

High Risk, Unaware?

Having already experienced complications from heart disease, all the participants in the study were at high risk for having a heart attack. Despite this fact:

  • 43% gauged their risk as less than or the same as people their age who did not have heart disease.
  • 47% of men thought they were low risk.
  • 36% of women thought they were low risk.

Compared to women, men were more confident that they would recognize signs of heart attack if they were having one or noticed symptoms in others, despite the fact that they knew less about symptoms than women did.

Time Is of the Essence

If you're having a heart attack, survival rates improve by 50% if you get medical care within an hour. Delaying treatment by even half an hour can reduce your survival odds.

If people don't think they are vulnerable to heart attacks, they may explain away the symptoms or not correctly convey them to their doctor. A lack of knowledge about heart symptoms and risk can delay treatment for many heart attack patients, the study states.

According to the study, from the time symptoms are first felt, on average it still takes someone having a heart attack about two and a half to three hours to be admitted to a hospital. Dracup and colleagues note that this statistic has not changed in 10 years.

The study's authors say heart attack patients used to spend longer periods of time in the hospital, where they could learn about their disease. The authors contend that reduced hospital stays have had a "dramatic effect on the time available" to educate patients.

The results appear in the May 26 issue of Archives of Internal Medicine.

Show Sources


Dracup, K. Archives of Internal Medicine, May 26, 2008; vol 168(10): pp 1049-1054.

News release, JAMA/Archives.

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