Do You Know the 5 Symptoms of a Heart Attack? Many Don't

Time is of the essence when you're having a heart attack.

But one in five Americans can't name the three most common symptoms of a heart attack, making it more likely they won't promptly respond to the life-threatening health crisis, a new study reports.

"More than 20% were unaware of the common symptoms of a heart attack," said senior researcher Dr. Khurram Nasir, a preventive cardiology specialist at Houston Methodist DeBakey Heart and Vascular Center. "The more likely you are unaware of the symptoms, the less likely you would be calling EMS [emergency medical services] in response to a perceived heart attack."

For this study, Nasir and his colleagues analyzed responses to the 2017 National Health Interview Survey, an annual federal survey of adults across the United States.

People were asked to name the symptoms related to a heart attack, which are:

• Chest pain or discomfort.
• Shortness of breath.
• Pain or discomfort in their arms or shoulders.
• Feeling weak, lightheaded or faint.
• Jaw, neck or back pain.

Only about half of adults surveyed were aware of all five symptoms, the researchers found, while about 6% were not aware of a single sign of heart attack.

A fifth of those surveyed could not name the three most common symptoms: chest pain, shortness of breath, and pain in the arms or shoulders.

"It's definitely a wake-up call for the major stakeholders, like the American Heart Association [AHA] and the CDC [U.S. Centers for Disease Control and Prevention]," Nasir said. "We need to make a substantial effort to improve the awareness of heart attack symptoms."

The groups most likely to be ill-informed regarding heart attack symptoms were men, minority and ethnic groups, people with lower education and lower socioeconomic status, and the uninsured, Nasir said.

Part of the problem might be that doctors and health experts aren't communicating these symptoms in kitchen-table language, said American Heart Association spokeswoman Dr. Nieca Goldberg.

For example, people might not understand that "most cardiac chest discomfort is a tightness or pressure in the setting of a heart attack. It's a very constricting feeling -- a feeling as though there's an elephant on your chest," said Goldberg, a cardiologist with NYU Langone Medical Associates in New York City.

Another example is shortness of breath, which could be described as "real difficulty breathing, as though you've ran a marathon but you haven't moved," Goldberg said. "It's really severe. You might not even be able to talk."

Patients with symptoms this severe should be calling for emergency help immediately, Goldberg said.

"In the setting of a heart attack, you should be calling 911 and not wasting time looking up your symptoms on a computer," she said.

However, folks should also know that the same symptoms that are so overwhelming when the heart attack strikes can crop up in lesser fashion weeks or months before the crisis, Goldberg added.

"Several weeks before, people might have similar symptoms but they're less intense and they ignore them," Goldberg said. "The idea is to recognize symptoms when they first start and call your doctor then, and sometimes with clogged arteries they actually occur in a less intense way weeks before."

Patients who notice these symptoms when they're more subtle can avoid a heart attack and a trip to the ER by seeing their doctor, who can refer them to a specialist and schedule them for a procedure to reopen clogged arteries, Goldberg said.

Despite the general lack of awareness, Nasir said there are signs in this survey data showing that public health campaigns can have an impact on people's knowledge of heart attack symptoms.

He noted that most recent informational campaigns related to heart attack have focused on women, such as the AHA's "Go Red for Women" initiative.

"We found women were nearly 10% more likely to be aware of all these symptoms than men," Nasir said. "It could be a reflection of the successful outreach of this campaign."

The new study was published online in JAMA Network Open.

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