Patients' interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction. Issue 4 (1st April 2000)

• Record Type: Journal Article
• Authors: Horne, R; James, D; Petrie, K; Weinman, J; Vincent, R
• Is Part Of: Heart. Volume 83:Issue 4(2000)
• Page Start: 388
• Page End: 393
• Publication Date: 2000-04-01
• Subjects: myocardial infarction -- symptoms -- delayed diagnosis; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.83.4.388
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : OBJECTIVE: To examine whether the association between expected symptoms of acute myocardial infarction and actual symptoms predicted delay in reaching hospital and help seeking behaviour. DESIGN: During hospital convalescence, participants completed a structured interview designed to measure symptom experience and help seeking behaviour following the onset of symptoms of acute myocardial infarction. PATIENTS: 88 patients admitted to hospital with their first myocardial infarction MAIN OUTCOME MEASURES: Delay in reaching hospital from onset of worst symptoms, obtained from ambulance and hospital records. RESULTS: The most common symptoms expected by patients with myocardial infarction were central chest pain (76%), radiating arm or shoulder pain (34%), and collapse (26%). The most common symptoms experienced were sweats or feeling feverish (78%), chest pain (64%), and arm, shoulder, or radiating pain (66%). A mismatch between symptoms experienced and those expected occurred in 58% of patients, and was associated with delay. Patients who experienced a mismatch between expectation and actual symptoms also were more likely to have a third party decide to call for help. CONCLUSIONS: The experience and interpretation of symptoms is an important source of delay and help seeking following onset of myocardial infarction symptoms.