Patient delay in treatment seeking for AMI affect outcome adversely, and differences in symptom experience may influence care-seeking behavior. Studies suggest that minorities, women, and older people delay longer and may present with different symptom profiles compared with younger white males. Data from the REACT Trial, a multi-center community intervention to reduce delays in treatment-seeking for AMI, were used to examine sociodemographic differences in symptoms.
ED records were abstracted for 5358 individuals in all 43 hospitals in 20 US communities. All individuals presented to study EDs with chest pain or synonymous complaints suggestive of AMI. The presence or absence of each of 21 symptoms was analyzed by sex, 10-year age group, and ethnicity.
Symptom presentation was found to differ significantly by sociodemographic characteristics. Patients in the two oldest groups were less likely than younger patients to report classic heart attack symptoms such as chest pain, chest pressure, diaphoresis, and arm pain or numbness. Back pain, headaches, palpitations and weakness were more common among women, while men reported more diaphoresis. Whites had more arm or jaw pain, chest pressure or discomfort, and diaphoresis compared with non-whites. African-Americans reported more coughing and vomiting than the other two groups. Hispanics were less likely to report indigestion, chest tightness, dyspnea or diaphoresis than whites or African-Americans.
These results have implications for developing educational materials to encourage rapid response to symptoms of AMI. Differences in symptom presentation should be incorporated into educational messages targeted toward different sociodemographic groups.
Learning Objectives: At the end of the session, the participant will be able to: 1. Recognize the importance of seeking treatment quickly for symptoms of AMI. 2. List the 4 most common symptoms of AMI. 3. Identify differences in presenting symptoms by ethnicity, age and sex. 4. Recognize the importance of accounting for these differences when developing a community intervention to reduce delays in treatment seeking
Keywords: Myocardial Infarction, Community Education
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Research supported by grants HL-53149, HL-53142, HL-53155, HL-53211, HL-53135, and HL-53141 from the National Heart, Lung, and Blood Institute, Bethesda, Md. Additional support for intervention materials was provided by Genentech, Inc, South San Francisco