Low level of knowledge of heart attack symptoms and inappropriate anticipated treatment-seeking behaviour among older Chinese: a cross-sectional survey

Chau, Pui Hing; Moe, Gordon W.; Lee, Siu Yin; Woo, Jean; Leung, Angela Yee Man; Chow, Clifton; Kong, Cecilia; Lo, Wing Tung; Yuen, Ming Hay; Zerwic, Julie Johnson

doi:10.1136/jech-2017-210157

Cited by 18 publications

(26 citation statements)

References 36 publications

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“…However, they are lower than those in Singapore 22 and South Korea. 23 Heart attack recognition rate was similar to a recent study of older Hong Kong adults, 8 yet similar deficits in the breadth of symptom knowledge were found: although chest pain was recognised by the majority of participants, recognition of other symptoms was relatively poor. Increasing awareness of multiple heart attack symptoms or patterns is important, because not all heart attack patients demonstrate all symptoms and women in particular often experience 'atypical' symptoms that may delay immediate action.…”

Section: Open Accesssupporting

confidence: 77%

“…15 A study of older Hong Kong residents found that more than 50% identified chest pain, shortness of breath, and dizziness as symptoms, and one-third recognised at least five of nine heart attack symptoms. 8 Moreover, a survey of Beijing and Shanghai residents 16 found that 15%-18% could not name even one heart attack symptom and the identification rates for other symptoms were lower than those reported in other studies, 8 15 possibly because participants were asked to recall rather than recognise symptoms.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 91%

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Public knowledge of stroke and heart attack symptoms in China: a cross-sectional survey

et al. 2021

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ObjectiveStroke and ischaemic heart disease have become the leading causes of death in China. We evaluated recognition of stroke and heart attack symptoms and stroke treatment-seeking behaviour in a large representative sample of the Chinese adult population and explored characteristics associated with recognition rates.DesignCross-sectional survey.SettingHousehold interviews.Participant3051 Chinese adults aged between 18 and 69 (50.7% female) were interviewed between January and March 2019.Primary and secondary outcome measuresPrimary measures include recognitions of stroke and heart attack symptoms and stroke treatment-seeking behaviour. Secondary measures include numeracy level, sociodemographics and prior history of cardiovascular diseases and high blood pressure.ResultsParticipants on average recognised 5.2 out of 14 stroke symptoms and 2.6 out of 6 heart attack symptoms. In the presence of stroke symptoms, three quarters of participants would take immediate action and call an ambulance, yet the second most common action was to advise the person to see a doctor (59%) rather than to consult a doctor immediately (34%). Recognition of atypical heartattack symptoms, such as nausea and feeling of anxiety, was poor. Symptom recognition rates were higher in females, people with a personal or family/friend history of cardiovascular events, those with higher numeracy scores, and for stroke symptoms, participants with high (versus low) education level. Furthermore, symptom recognition rate was negatively correlated with burden of cardiovascular diseases across the four economic regions of China.ConclusionRecognition of stroke and heart-attack symptoms was moderate and there remains a gap between recognising symptoms and taking immediate action. Interventions focusing on simple symptom detection tools and on building numerical competencies may help reduce the burden of cardiovascular diseases in China.

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Section: Open Accesssupporting

confidence: 77%

Section: Strengths and Limitations Of This Studymentioning

confidence: 91%

Public knowledge of stroke and heart attack symptoms in China: a cross-sectional survey

et al. 2021

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“…[13] Of note, seeking non-emergent medical care was the most popular action when no chest pain occurs. [14] In summary, these data as well as our results highlighted that improvement in the management of AMI is still needed. First, patients should be educated more about possible symptoms of AMI, particular atypical symptoms in order to reduce prehospital patient delay and receive medical care as soon as possible.…”

Section: Discussionsupporting

confidence: 52%

Differences in symptoms and pre-hospital delay among acute myocardial infarction patients according to ST-segment elevation on electrocardiogram

Song

Dou

et al. 2019

Chinese Medical Journal

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Background:Approximately 70% patients with acute myocardial infarction (AMI) presented without ST-segment elevation on electrocardiogram. Patients with non-ST segment elevation myocardial infarction (NSTEMI) often presented with atypical symptoms, which may be related to pre-hospital delay and increased risk of mortality. However, up to date few studies reported detailed symptomatology of NSTEMI, particularly among Asian patients. The objective of this study was to describe and compare symptoms and presenting characteristics of NSTEMI vs. STEMI patients.Methods:We enrolled 21,994 patients diagnosed with AMI from China Acute Myocardial Infarction (CAMI) Registry between January 2013 and September 2014. Patients were divided into 2 groups according to ST-segment elevation: ST-segment elevation (STEMI) group and NSTEMI group. We extracted data on patients’ characteristics and detailed symptomatology and compared these variables between two groups.Results:Compared with patients with STEMI (N = 16,315), those with NSTEMI (N = 5679) were older, more often females and more often have comorbidities. Patients with NSTEMI were less likely to present with persistent chest pain (54.3% vs. 71.4%), diaphoresis (48.6% vs. 70.0%), radiation pain (26.4% vs. 33.8%), and more likely to have chest distress (42.4% vs. 38.3%) than STEMI patients (all P < 0.0001). Patients with NSTEMI were also had longer time to hospital. In multivariable analysis, NSTEMI was independent predictor of presentation without chest pain (odds ratio: 1.974, 95% confidence interval: 1.849–2.107).Conclusions:Patients with NSTEMI were more likely to present with chest distress and pre-hospital patient delay compared with patients with STEMI. It is necessary for both clinicians and patients to learn more about atypical symptoms of NSTEMI in order to rapidly recognize myocardial infarction.Trial Registration:www.clinicaltrials.gov (No. NCT01874691).

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“…During COVID-19, people would be too afraid of getting infected to seek medical treatment. On the other side, it has been demonstrated that patients know little about AMI symptoms [18]. However, the S2FMC time of patients with AMI has not been delayed due to the COVID-19 epidemic in 2020. is might be related to the establishment of Chest Pain Center (CPC) in Chinese hospitals in recent years.…”

Section: Discussionmentioning

confidence: 99%

The Number of Patients with Acute Myocardial Infarction Decreased and Door-to-Balloon Time Delayed in COVID-19

Huang

et al. 2021

Cardiology Research and Practice

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Background. At present, COVID-19 is sweeping the world, and all countries are actively responding. During the COVID-19 epidemic, the treatment of patients with acute myocardial infarction (AMI) may be affected. Methods. We reviewed data of patients with AMI from January 23 to April 23, 2020 (2020), and January 23 to April 23, 2019 (2019), who were admitted to two hospitals from Southern China. We collected clinical characteristics, comorbidities, treatment, prognosis, and key time segments to analyze. Results. The total number of patients that had been diagnosed with AMI in the two hospitals was 218 in 2020 and 260 in 2019. The number of AMI patients that were admitted to hospitals per day decreased in 2020. The percentage of patients with AMI who refused hospitalization in 2020 was significantly higher than that in 2019 (5.0% vs 1.5%, p = 0.028 ). There is no statistical difference in symptoms of the first medical contact (S2FMC) time between 2020 and 2019 ( p = 0.552 ). Door-to-balloon (D2B) time of ST-elevation myocardial infarction (STEMI) patients who were treated with a primary percutaneous coronary intervention (pPCI) in 2020 was 79 (63.75–105.25) mins, while D2B time in 2019 was 57.5 (41.5–76.5) mins, which was statistically different from the two groups. Conclusions. COVID-19 had an impact on the number of AMI patients who were admitted to hospitals and the time of treatment. During the COVID-19 epidemic, the number of AMI patients that were admitted to hospitals per day was decreased, while the percentage of AMI patients that refused therapy in these two hospitals increased, and the D2B time of STEMI patients was also delayed.

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Low level of knowledge of heart attack symptoms and inappropriate anticipated treatment-seeking behaviour among older Chinese: a cross-sectional survey

Abstract: To minimise delays in seeking treatment, future health education should focus on increasing the public knowledge of AMI symptoms and the need to call an ambulance during an emergency.

Cited by 18 publications

References 36 publications

Public knowledge of stroke and heart attack symptoms in China: a cross-sectional survey

Public knowledge of stroke and heart attack symptoms in China: a cross-sectional survey

Differences in symptoms and pre-hospital delay among acute myocardial infarction patients according to ST-segment elevation on electrocardiogram

The Number of Patients with Acute Myocardial Infarction Decreased and Door-to-Balloon Time Delayed in COVID-19

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