Are doctors missing early warning signs of heart attacks?

Research by the Imperial College London has found that up to 16% of people who died of heart attacks between 2006 and 2010 had been admitted to hospital in within the previous 28 days, but their symptoms were not considered to be heart attack-related.

Early symptoms of heart attacks

Early symptoms of heart attacks can present up to a month before death, for example, fainting, shortness of breath and chest pain, and these symptoms were noted among a number of the above patients who died. Dr Perviz Asaria, lead author of the study, commented on the findings,

“Unfortunately, in the four weeks following a hospital stay, nearly as many heart attack deaths occur in people for whom heart attack is not recorded as a primary cause, as occur after an admission for heart attack.”

A heart attack every three minutes

According to the British Heart Foundation, someone in the UK will experience a heart attack every 3 minutes, and of those 30% are fatal. Dr Asaria argues that the problem isn't with the treatment of heart attacks, but with the ability to recognise the early symptoms that do not lead to a heart-attack related hospital admission. The paper's co-author, Professor Majid Ezzati, says there's further research needed,

"We cannot yet say why these signs are being missed, which is why more detailed research must be conducted to make recommendations for change. This might include updated guidance for healthcare professionals, changes in clinical culture, or allowing doctors more time to examine patients and look at their previous records."

It's also harder to recognise the signs of a cardiac episode in women, as they can present with different symptoms to men. While the most common sign of heart attack in men is chest pain, women are more likely to present with nausea, dizziness and shortness of breath, without the presence of actual pain. This could explain why women 50% more likely to be misdiagnosed.

Women's heart problems misdiagnosed

Research by the University of Leeds on 600,000 patients found that women, in particular, were being let down and being diagnosed with minor ailments like indigestion and mild chest and neck pain. Among both men and women, about 30% of patients had an initial diagnosis that was different from what was concluded as their final diagnosis. Dr Chris Gale, the lead researcher and associate professor of Cardiovascular Health Sciences at the University of Leeds said,

“A lot of this is about education and awareness - partly among the public, to know that the signs of a heart attack aren't just chest pain - but also among doctors who aren't cardiologists. The risk is that a woman presents late because she doesn't recognise that she is having a heart attack so she goes to her GP, and then they don't call for an ambulance so instead she ends up going to A&E eventually, and by the time she gets to see a specialist it's a late diagnosis."

Talk to your GP about your individual risk of heart disease and what signs you should look out for. Twenty-five Harley Street Day Clinic has a number of GP's and medical specialist who can help discuss any concerns you have.

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