Many patients thought that their symptoms were not severe enough to be a heart attack, confusing them with symptoms of angina or indigestion. Some who had already had treatment believed they were no longer at risk of another heart attack.

Twenty patients reported that the symptoms were not similar to those of any previous attack, while others admitted that, illogically, they hoped it would go away.

All but one of the patients felt a concern about wasting NHS time and resources, especially ambulances. Even those who had previously been told to phone an ambulance felt reluctant to do so. People were also reluctant to seek medical help during the night and at weekends.

The decision to seek medical help is a complex interaction of knowledge and experience, beliefs, emotions, and the context of the event, say the authors. Simply providing patients with information on symptoms of a heart attack, and what to do in the event of these symptoms, may not be sufficient to promote prompt action, they conclude.

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Contact: Emma Wilkinson
ewilkinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
25-Apr-2002