Abstract 16114: How Does the Symptom Experience Differ From Patient’s Expectations of What Having a Heart Attack is Like?
Introduction: Early recognition of heart attack symptoms is key to reducing delays in seeking medical attention. Over a decade ago it was identified that the symptom experience in the majority of AMI patients (74%) did not match the patient’s expectations. Given the extent of public education since that time, this study aims to provide a current perspective and to examine how the experience was different.
Methods: Interviews were conducted with consecutive acute myocardial infarction (AMI) patients admitted to a metropolitan hospital in Melbourne (Australia) between July 2013 and April 2014. Patients were included if they were: aged 35-75 years, competent to provide consent, English speaking, not in residential care, and medically stable. Content analysis was performed to identify themes around how the experience was different.
Results: Interviews were conducted with 128 patients admitted for STEMI (32%), and NSTEMI (67%). The mean age was 59 years (SD=10), 71% (n=91) were male and 29% (n=37) had a history of ischaemic heart disease. Although the majority (81%) experienced chest pain, only 37% thought their symptoms were heart-related at symptom onset -other common attributions were stomach-related problems (22%) and muscular pain (10%). A small group (11%) had no previous expectation of what a heart attack might be like, the remainder thought their experience was nothing like their expectation (20%), somewhat like (32%) or exactly like (37%). Patients in the later group were more likely to have a history of IHD (42% vs. 21%, p=0.009). Four themes were identified in those in whom the experience was different to previous expectations: different pain severity (47%), different onset (33%), different symptoms experienced (21%) and different location of pain (21%).
Conclusion: In most AMI patients the symptom experience was different to what they expected a heart attack to be like -this has not changed over the last decade. Interventions to address the public’s perception of the heart attack experience are still needed.
- Acute coronary syndromes
- Patient education/teaching psychosocial aspects
- Health promotion
- Myocardial infarction
Author Disclosures: J.E. Bray: None. D. Stub: None. P. Ngu: None. S. Cartledge: None. J. Shaw: None. J. Finn: None.
- © 2014 by American Heart Association, Inc.