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Delay in calling for help during myocardial infarction: reasons for the delay and subsequent pattern of accessing
1Department of Human Nutrition, University of Glasgow, Glasgow Royal Infirmary, UK. wsl2n@clinmed.gla.ac.uk
Insights
Most heart attack patients experienced significant delays in seeking help due to misinterpreting symptoms. Many opted for general practitioners over emergency services, highlighting a need for public education on recognizing acute myocardial infarction symptoms and prompt hospital care.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute myocardial infarction (AMI) poses a significant health burden.
- Patient delay in seeking treatment for AMI is a critical factor influencing outcomes.
Purpose of the Study:
- To investigate the reasons behind delayed help-seeking behavior during AMI.
- To understand the factors influencing the choice of first medical contact for AMI patients.
Main Methods:
- A community survey was conducted in Glasgow.
- Data were collected through routine medical record reviews and semi-structured interviews.
- The study included 228 men and 85 women who survived AMI between 1994 and 1996.
Main Results:
- A substantial delay in seeking help was observed, with only 25% calling within one hour and 40% delaying over four hours.
- The majority of patients did not recognize their symptoms as cardiac-related.
- Common reasons for delay included underestimation of symptom severity and belief they would resolve spontaneously.
- General practitioner (GP) attendance was the first choice for 55% of patients, often due to a perceived protocol.
- Reluctance to use emergency services stemmed from a belief that symptoms were not severe enough for an ambulance.
Conclusions:
- Public education is crucial to improve recognition of diverse coronary symptoms.
- Emphasizing the benefits of prompt hospital presentation via emergency services is necessary.
- Targeted strategies are needed to reduce patient delay in this urban population.
Objective:
To determine the reasons for delay in calling for help during acute myocardial infarction and the reasons for choice of first medical contact.
Design:
Review of routine medical records and one to one semi-structured interviews.
Setting:
Community survey in city of Glasgow, north of the river Clyde.
Patients:
228 men and 85 women aged between 25 and 65 years, respectively, who survived acute myocardial infarction between October 1994 and December 1996.
Results:
Only 25% of the subjects made a call for help within one hour of the onset of coronary symptoms; in 40% the delay was greater than four hours. Symptoms were not recognised as coronary in origin in the majority of cases. In all cases where delay was more than one hour the main reasons for the delay were thinking that symptoms would go away or that they were not serious. Requesting the attendance of a general practitioner was the first course of action in the majority of cases (55%); the main reason given was that the patient believed this should always be the first course of action. Reluctance to call the emergency services reflected the belief that the symptoms were not serious enough to warrant an ambulance.
Conclusions:
Strategies to reduce patient delay times in this deprived urban population must focus on educating the public on the recognition and diversity of coronary symptoms and the benefits of presenting promptly to hospital by way of the emergency ambulance service.