Heart attack delays linked to symptoms

Most people who suffer heart attacks experience crucial delays in treatment because their symptoms do not appear as “Hollywood-style” fast-onset events.

Prevailing expectations and perceptions about the symptoms of heart attacks are a major factor in pre-hospital delays in treatment, a study by scientists at the school of nursing and midwifery in Trinity College Dublin found.

Almost 900 patients in five hospitals were examined for the study, which looked at the type of symptoms they experience when having a heart attack and the length of time it took for them to get to hospital.

The researchers found 65 per cent of patients experienced slow-onset acute coronary syndrome involving slow, milder and more intermittent symptoms. The rest experienced the classic fast-onset event characterised by sudden, intense and severe chest pain, tightness and discomfort.

The type of symptoms directly influenced the time it took patients to get to an emergency department or treatment by paramedics, the study in the Journal of Emergency Medicine found.

Patients with slow-onset symptoms took on average 1½ times longer to arrive at an emergency department than those with fast-onset symptoms. They were more likely to first phone or visit their GPs.

Delays in treating a heart attack can have a significant impact on a person’s chances of survival and future health. Anyone experiencing a heart attack should receive life-saving treatment within two hours of the attack at most.

The slow-onset heart attack patients in this study had an average 3½-hour pre-hospital delay, considerably outside the recommended optimum time for treatment, compared with two hours for the fast-onset patient group.

Dr Sharon O’Donnell, director of undergraduate teaching and learning at Trinity’s nursing school, said clinicians had to be aware that most heart attacks have a slow onset and that this group of patients needed to be assessed and treated as quickly as possible.