Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;51(12):983-996.
doi: 10.4070/kcj.2021.0100. Epub 2021 Sep 1.

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

Affiliations

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

Akash Sharma et al. Korean Circ J. 2021 Dec.

Abstract

Background and objectives: Knowledge about myocardial Infarction (MI) symptoms is crucial because inadequate awareness ensures direct association with patient delay and adverse health events subsequently.

Methods: PRISMA guidelines were followed while conducting the systematic review with PROSPERO number CRD42020219802. An electronic search was conducted comprehensively through 5 databases to find those relevant articles systematically. Prevalence was calculated for each typical symptom of MI separately and subgroup analysis according to continent, country, gender and ethnicity was done. Meta-Analysis was conducted by using statistical software R version 3.4.3. A random-effects model was used.

Results: Studies from 35 different countries with 120,988,548 individuals were included in the final analysis. The prevalence of chest pain awareness was highest, while it was lowest for jaw, back, and neck pain. There was no difference in terms of awareness in males and females. Prevalence of awareness of typical MI symptoms was higher in the Caucasian white, white, and non-Hispanic white groups than in other groups. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and Asian countries such as Nepal to as high as 90% in Germany.

Conclusions: People are well aware of chest pain as a symptom of MI. However, there is limited knowledge regarding other typical symptoms of MI.

Keywords: Awareness; Meta-analysis; Myocardial infarction; Prevalence.

PubMed Disclaimer

Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1. PRISMA flow diagram of the study screening and selection process.
GHL = Global Health Library; MI = myocardial infarction; VHL = Virtual Health Library.
Figure 2
Figure 2. Global prevalence awareness of all typical symptoms of MI of different countries.
MI = myocardial infarction.
Figure 3
Figure 3. Prevalence of awareness of chest pain as symptom of MI of different countries with 95% CI stratified by continents.
CI = confidence interval; MI = myocardial infarction.
Figure 4
Figure 4. Prevalence of awareness of shortness of breath as symptom of MI of different countries with 95% CI stratified by continents.
CI = confidence interval; MI = myocardial infarction.
Figure 5
Figure 5. Prevalence of awareness of pain and arm discomfort as symptoms of MI of different countries with 95% CI stratified by continents.
CI = confidence interval; MI = myocardial infarction.
Figure 6
Figure 6. Prevalence of awareness of jaw, neck, and back pain as symptoms of MI in different countries with 95% CI stratified by continents.
CI = confidence interval; MI = myocardial infarction.
Figure 7
Figure 7. Prevalence of awareness of feeling weak and light-headedness as symptoms of MI in different countries with 95% CI stratified by continents.
CI = confidence interval; MI = myocardial infarction.

References

    1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–1222. - PMC - PubMed
    1. World Health Organization. The top 10 causes of death [Internet] Geneva: World Health Organization; [cited 2021 February 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.
    1. World Health Organization. Health topics: cardiovascular disease [Internet] Geneva: World Health Organization; [cited 2021 February 16]. Available from: https://www.who.int/health-topics/cardiovascular-diseases.
    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442. - PMC - PubMed
    1. Johns Hopkins Medicine. Heart attack [Internet] Baltimore (MD): Johns Hopkins University; [cited 2021 February 16]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-attack.