Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review

Abstract

Background Since the knowledge of the symptoms of acute myocardial infarction (AMI) may reduce the decision time for patients to seek help in case of an AMI, we aimed to summarize evidence on the knowledge of the AMI symptoms and the symptom attribution in case of an acute coronary syndrome (ACS). Methods Therefore, we systematically searched the databases PubMed, CINAHL, Embase, and Cochrane Library for relevant studies published between January 1, 2008 and 2019 (last search August 1, 2019). Results A total of 86 studies were included, with a composite sample size of 354,497 participants. The weighted mean of the knowledge scores for the symptoms of AMI of 14,420 participants from the general population, was 42.1% (when maximum score was considered 100%) and 69.5% for 7642 cardiac patients. There was a substantially better level of knowledge for six symptoms (‘chest pain or discomfort’, ‘shortness of breath’, ‘pain or discomfort in arms or shoulders’, ‘feeling weak, lightheaded, or faint’, ‘pain or discomfort in the jaw, neck, or back’, and ‘sweating’) (49.8–88.5%) compared to the four less obvious/atypical symptoms ‘stomach or abdominal discomfort’, ‘nausea or vomiting’, ‘headache’, and ‘feeling of anxiety’ (8.7–36.7%). Only 45.1% of 14,843 patients, who experienced ACS, have correctly attributed their symptoms to a cardiac cause. Conclusion In conclusion, we found a moderate to good knowledge of “classic” and insufficient knowledge of less obvious symptoms of AMI. This might suggest that increasing knowledge about less obvious symptoms of AMI could be beneficial. It appears also important to address cardiac attribution of symptoms.

Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis

“…Seeking medical attention lately by delaying from the onset of heart attack symptoms is of international concern. In a systematic review done by Birnbach et al 31) , including 86 articles, weighed mean for chest pain as a symptom of MI was found to be 74.3% which is in line with the pooled prevalence of 70% for awareness for chest pain as a symptom of MI reported by our study. Fourteen studies (China, Bangladesh, Ireland, USA, Australia, Germany, Spain, USA, Jordon [2], UK [2], Brazil, Sweden) involved patients with a history of the previous diagnosis with MI.…”

The efficacy of a short one-on-one nursing intervention in people with coronary heart disease

“…Better knowledge of ACS symptoms has sometimes been found to be associated with shorter prehospital delay times. [ 19 ] Enhancing knowledge must be considered an essential first step to promoting appropriate patient behavior in responding to ACS symptoms. Currently, few interventions have used one-on-one delivery of the information and few investigators have evaluated intermediate outcomes that potentially influence patient treatment-seeking behavior in response to ACS symptoms.…”

Sensation of laryngeal obstruction as a manifestation of myocardial infarction: A case report

“… 7 , 8 Furthermore, research has shown that the general population as well as many clinicians have insufficient knowledge of the atypical symptoms of AMI. 9 One study that compared risk factors in patients with typical and atypical MI found that older patients and those with low cholesterol levels were more likely to present with atypical MI compared with younger patients. 10 In addition, another study reported that that old age (≥75 years), female sex, diabetes mellitus, history of acute MI, and absence of hyperlipidaemia were five independent predictors for atypical symptom presentation of ACS.…”