Better detection of early warning signs could save many lives
In the event of a heart attack, it is particularly important that early warning signs are recognized as quickly as possible. It is then possible for the person concerned to receive optimal treatment. English researchers have now found, however, that the early warning signs of such a disease are unfortunately not recognized by many doctors and hospital staff.
Scientists at Imperial College London found in an investigation that many people fail to recognize the early warning signs of a heart attack in hospitals. The doctors published the results of their study in the journal "The Lancet".
Important early warning signs are not correctly recognized in hospitals
Apparently doctors often do not recognize the signs of a heart attack. As a result, approximately one in ten patients in English hospitals dies of a fatal heart attack, the authors of the study explain. For their investigation, the doctors analyzed the heart attacks and related deaths in hospitals between 2006 and 2010.
16 percent of the deceased had previously visited a hospital
Experts from Imperial College London found that around 16 percent of those who died had gone to hospital in the past 28 days. Some of them already had warning signs, such as chest pain. More research on this topic is urgently needed, the scientists explain.
Doctors are investigating 135,950 deaths from a heart attack
Overall, the researchers looked at the hospital records of all 135,950 deaths in England that resulted from heart attacks over a period of four years. The records showed whether the affected persons had been hospitalized in the last four weeks before their death and whether signs of a heart attack were recorded as the main reason for the admission, as a secondary reason or even not at all, the scientists explain.
In 21,677 patients there was no mention of symptoms of a heart attack
The evaluation of the available data showed that in 21,677 patients no mention of symptoms of a heart attack was recorded in the hospital records. Doctors are very good at treating heart attacks if they are the main cause of hospitalization, the researchers say. However, the situation looks very different if a heart attack is not the main cause of hospitalization. It is difficult for doctors and hospital staff to recognize a heart attack due to subtle signs, explains the author Dr. Perviz Asaria from Imperial College London.
What are the typical symptoms of a heart attack?
If more of these signs were recognized early, it would be possible to avoid many unnecessary deaths as a result of heart attacks, the doctors explain. Typical symptoms include:
Chest pain (a feeling of pressure or tightness in the middle of the chest)
- Pain in other parts of the body (for example, pain that spreads from the chest to the arms, usually affecting the left arm, but may also affect the jaw, neck, back, and abdomen)
- shortness of breath
Nausea and vomiting
- Overwhelming feelings of fear (similar to panic attacks)
- coughing and wheezing
Chest pain that occurs is not always dominant
The chest pain is usually very severe, but there are also some cases in which there is little pain, similar to indigestion, the experts say. In some cases, there may even be no chest pain at all, especially in women, the elderly, and people with diabetes.
Symptoms can appear a month before a fatal heart attack
Certain symptoms such as fainting, shortness of breath and chest pain usually occurred up to a month before death in some patients. Doctors do not always respond properly to these symptoms of a fatal heart attack because there are no obvious damage to the heart at this time, the authors explain.
More research is needed
We cannot yet say exactly why these characters are often overlooked. For this reason, the researchers emphasize that more detailed studies need to be carried out on the subject. This is the only way to make effective recommendations for change, says Professor Majid Ezzati from Imperial College London.
Updated guidance from healthcare professionals is required
This could lead to updated guidance for healthcare professionals. For example, doctors could then take more time to check the patients and examine the previous records for typical signs of a heart attack. The results of the study clearly show that a large number of people who later die from a heart attack visited a hospital the month before. However, no heart disease was diagnosed in those affected, the professor added.
A quick and accurate diagnosis must be guaranteed in the future
Many heart attacks manifest themselves through classic chest pain in people who are smokers and have other risk factors for heart disease. However, a large number of heart attacks are completely different, especially for people with a not so obviously high risk, the experts say. The challenge is to diagnose all of these patients accurately and quickly. Only in this way can those affected be guaranteed optimal care. (as)