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. 2000 Apr;83(4):388-93.
doi: 10.1136/heart.83.4.388.

Patients' interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction

R Horne  1 , D James, K Petrie, J Weinman, R Vincent
Affiliations

Patients' interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction

R Horne et al. Heart. 2000 Apr.

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.

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Figures

Figure 1
Figure 1
Left panel: expectations and experience of "typical" cardiac symptoms. Right panel: expectations and experiences of "atypical" symptoms.
See this image and copyright information in PMC

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