Filenews 27 May 2021
One in four heart attacks will show symptoms that are not consistent with typical warning signs such as chest pain, with risk ignorance likely leading to death within 30 days. The new scientific finding is published in the European Heart Journal—Acute Cardiovascular Care of the European Heart Association (ESC).
Difficulty breathing, loss of consciousness, exhaustion and abdominal pain are atypical signs of an impending heart attack, according to research by Nordsjællands Hospital in Denmark. "We found that atypical symptoms occurred mainly in older people, especially women, who did not alert the emergency room," said study author Amalie Lykkemark Møller, a PhD candidate, about the great importance of patients and doctors immediately recognizing the signs of risk to prevent an inevitable outcome.
The study investigated the links between early heart attack symptoms, response from medical services and mortality at 30 days, according to all 24-hour calls made to a medical support line and one separate for emergencies in the Danish Capital Region for 2014-2018. Of the above services that record the main symptom along with the response, the researchers identified adults 30 years of age and older who received a heart attack diagnosis within 72 hours of the call and distinguished them into two groups depending on the main symptom.
More than three times the risk of death
During the five-year study, a specific initial symptom was recorded in 7,222 cases of heart attack out of a total of 8,336.72% for chest pain and 24% for atypical symptoms, with respiratory problems dominant. Especially:
- chest pain was more common in men aged 30-59 who called the emergency room and rarer in women, but who addressed the simple helpline. 95% addressed to the emergency room and 76% to the simple medical support line were taken to emergencies, with mortality at 30 days at 5% and 3% respectively for both groups
- atypical symptoms were associated with higher mortality, 23% for those who alerted the emergency room and 15% for those who called the helpline. In addition, an emergency ambulance was sent to only 67% of the emergency room team and 17% of the simple medical support team.
However, the risk of death was shown to be three times higher for the group of atypical symptoms compared to those who experienced chest pain, after adjusting data such as age, gender, educational level, diabetes, history of heart attacks, heart failure and chronic obstructive pulmonary disease. In particular, mortality was 15.6% compared to 4.3% respectively and, most likely, due to delayed assistance, Ms Møller estimates.
Commenting on the findings, Ms Møller referred to the nature of these atypical symptoms which make it difficult to suspect a heart attack, as these are conditions usually caused by other causes. "We hope that our study will raise awareness and inform older patients and health professionals in particular about these atypical warning signs," he said.
