Patterns of responses to cardiac events over time

Prompt treatment of acute coronary syndrome (ACS) is essential to reduce mortality and morbidity, but patients often delay seeking healthcare, regardless of their history of heart disease. The purpose of this study was to examine the responses to cardiac events in relation to delay time and past experience with similar symptoms in a sample of Lebanese patients.

Secondary analysis of data from a descriptive cross-sectional survey of a convenience sample of 210 patients with ACS admitted to a tertiary care center in Lebanon and recruited within 72 hours of admission was conducted. Data on demographic and clinical variables were obtained from medical records. Patients were interviewed using the Response to Symptoms Questionnaire and asked about their prior experience with symptoms similar to their current ones.

Delay time and the behavioral responses did not differ by past experience with similar symptoms, despite better recognition of symptoms as cardiac and knowledge of myocardial infarction symptoms in patients who had past experience. In both groups, those with past experience and those without one, delay time was significantly correlated with the characteristics and patients' appraisal of the symptoms. Inappropriate immediate responses, such as taking analgesics or resting, persisted with subsequent experience of cardiac events. Seeking emergency care was the least commonly used response and was used even less frequently with prior experience. The findings suggest lack of recognition of the appropriate response to ACS and probable issues with access to the health system. There is a need to emphasize the importance of prompt seeking of care when experiencing ACS, especially upon a repeated occurrence, and educate patients about the variability of clinical manifestations of ACS.