People Can’t Recognize a Heart Attack with Gradual Symptoms

Photo of author

( — September 29, 2019) — When the symptoms of a heart attack occur gradually and do not present themselves after major physical efforts, patients are less likely to consult calling an ambulance, US scientists concluded.

Of the 474 US patients who went to the emergency room with a dangerous reduction in blood flow to the heart muscle, those whose symptoms occurred gradually took six hours longer than recommended to call for help and arrive at the hospital, US doctors found.

They stated that because of the interruption of blood flow to the heart muscle, the cells of the heart begin to die off, and the patient feels a more or less pronounced chest pain.

Namely, a large number of patients did not recognize such gradual symptoms, although they were considering calling an ambulance.

As a consequence of subsequent reporting to the emergency room, assistance was given to them within eight hours of the onset of signs of a heart attack, compared with an average of 2.57 hours required for patients who had sudden and severe symptoms, the team of scientists published in the expert European Journal of Cardiovascular Nursing.

The American Heart Association’s (AHA) recommendations state that heart attack patients are advised to receive appropriate medical care less than two hours after the onset of symptoms to ensure they have the best chance to avoid permanently damaging the heart muscle.

In a sudden heart attack, patients experience very severe chest pain from the very beginning. But the symptoms of a gradual attack may not indicate an obvious heart attack, the authors note. That means that patients are not aware they are having a heart attack.

The symptoms are usually a feeling of mild discomfort in the middle of the chest that lasts for a few minutes or disappears and then reappears, pain in one or both hands, in the back, neck, jaw or abdominal cavity, accompanied by a shortness of breath. Also you may experience symptoms you do not normally feel, such as a sudden onset of cold sweat, nausea, fainting, general fatigue, or an inexplicable feeling that everything will collapse.

“Patients who experience a heart attack should not think that the symptoms they are experiencing are actually a false alarm,” said Dr. Sahereh Mirzaei of the University of Illinois at Chicago, who is also the study leader. She urges patients with the abovementioned symptoms to “call an ambulance or get help as soon as possible.”

The authors analyzed data on patients who participated in a larger study. The results of their analysis focused on 343 men and 131 women, ages 29-93.

Due to health problems, they were admitted to the emergency department at their nearest hospitals and later confirmed to be suffering from the acute coronary syndrome – a sudden decrease in blood flow to the heart muscle.

Nearly half of the respondents, about 44 percent, reported gradual symptoms of heart attack, while others reported sudden attack. Interestingly, half of the respondents took four hours or more to call the ambulance service.

A typical heart attack was more common in young patients, aged 35 to 40 years or those older than 75 years, as well as in patients with diabetes, especially in women.