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

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

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.

MeSH terms

  • Aged
  • Angina Pectoris / etiology
  • Attitude to Health
  • England
  • Female
  • Health Behavior
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / psychology
  • Patient Acceptance of Health Care*
  • Time Factors