Knowledgeable Patients Ignore Chest Pain
Patients Who Are Counseled on Heart Attack Symptoms Don't Seek Prompt Care
By Caroline Wilbert
WebMD Health News
Reviewed By
Elizabeth Klodas, MD, FACC
Oct. 7, 2009 -- When it comes to seeking treatment for chest pain, education doesn't
always mean people do the right thing.
In a new study, heart patients who received
counseling about heart attack symptoms and when
to get treatment were no more likely to get immediate care than those who had
not received counseling. This is disappointing because patients who receive
care within 90 minutes after the onset of heart attack symptoms fare much
better.
The study, published in Circulation: Cardiovascular Quality and
Outcomes, included 3,522 patients with documented heart disease. Patients had a
mean age of 67 years; two-thirds were men. About half of the patients received
counseling. During the next two years, 565 of the study participants were
admitted to the hospital with chest pain symptoms. Some were admitted more than
once.
Even after learning the value of getting to the hospital quickly and using
the emergency medical system (EMS), the group that received counseling was not
significantly more likely to do these things than the comparison group that
didn't get counseling.
The delay time -- the time between symptom onset and the hospital visit --
was 2.2 hours for the group that got the counseling and 2.25 hours for the
group that didn't get the counseling. The counseled group used the emergency
medical system 63.6% of the time, compared to 66.9% for the group without the
counseling.
The only good news? The group that got counseling was more likely to take an
aspirin and was more likely to
call the emergency medical system if chest pain occurred within six months of
the counseling.
In an accompanying news release, Alice Jacobs, MD, past president of the
American Heart Association and professor of medicine at Boston University
School of Medicine, listed common reasons that patients resist seeking
care:
- Fear the incident will be an embarrassing false alarm
- Not wanting to "bother" care providers
- Concern that insurance won't cover emergency care
"This study again underscores the importance of ongoing research in this
area targeted at finding what will change the behavior of patients and the
public at high risk for coronary events," Jacobs said in a statement.
SOURCES: Dracup, K. Circulation: Cardiovascular Quality and Outcomes, 2009.
News release, American Heart Association.
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