Only one in five Americans gets to the hospital within an hour of having the first symptom of a heart attack, say the heart association and the National Heart, Lung and Blood Institute. That means heart attack victims are not getting the early emergency treatment with clot-buster drugs or other medical interventions that could lessen the damage to their hearts, the groups say.
The joint call for action to physicians and their patients was made at a news conference today in Washington, D.C. -- the day before National 911 Day.Americans should learn all the signs of a heart attack and make it family policy to call 911, the experts say. The National Emergency Number Association first started calling attention to Sept. 11 (9-11) to urge people to call for emergency help. The Ohio-based educational group supports technology, training and other avenues to establish a universal emergency phone number.
People think a heart attack is one of those pounding, chest-clutching affairs, says Dr. James Atkins, professor of internal medicine at the University of Texas Southwestern Medical School in Dallas, and the chairman of the executive committee of the National Heart Attack Alert Program.
"They think a heart attack is like one of the classic ones they've seen in the movies: John Wayne suddenly grabbing his chest and collapsing to the floor," Atkins says. "That's what most people think a heart attack is like -- and that's not what it's like at all."
A heart attack can come in a variety of disguises -- a pain in the neck, or in the jaw, some slight nausea or a cold sweat, Atkins says. "Some people have a little pain, or some discomfort, something that lasts more than five minutes," he says. "It's a different feeling than they've had before, and they keep trying to figure out what it is."
But people need to realize that the earlier you get to the emergency room, the better your chances for survival, Atkins says.
"If people are treated with these clot-buster drugs or a balloon or a stent [a tube to hold the artery open] within the first hour [after symptoms start], the mortality rate is 1.6 percent," Atkins says. "But if they're not treated within the first hour, the mortality rate jumps to 6 to 8 percent, and it's even higher after eight to 12 hours, when the mortality rate soars to 10 to 12 percent." Using balloon angioplasty allows doctors to widen a clot-blocked artery.
The problem, however, is not only with identifying the symptoms of a heart attack, Atkins says: "Women and minorities tend to delay longer."
"There's an impression that heart disease is a white male disease," Atkins explains. "But more women die of heart disease than men -- 60,000 more women a year. But only 18 percent realize that heart disease is also a woman's problem. They think breast cancer is the problem. But breast cancer kills about 10 percent of the women who die annually, while heart disease kills 50 percent."
Minorities tend to delay even longer, thinking it's a white-only problem or because they have problems with access to health care, Atkins adds.
According to the American Heart Association, sudden cardiac arrest kills about 220,000 people each year -- or three lives every seven minutes.
"Our REACT [Rapid Early Action for Coronary Treatment] study showed, when we interviewed people, that over 90 percent of them said they would dial 911 if they were having symptoms of a heart attack," says Dr. Sidney Smith, the chief science officer for the American Heart Association and a professor of medicine at the University of North Carolina in Chapel Hill. "And yet when we interviewed patients admitted to emergency rooms, only one in four had called 911." The REACT study also showed that people could identify only 30 percent of heart attack symptoms, Smith adds.
"The American Heart Association wants to raise people's awareness of how to deal with a heart attack," Smith says. "The whole family needs to talk about this. People need to understand that you don't ask a friend or a neighbor or a family member to drive you to the hospital. You need to dial 911 and leave your care up to the professionals."
What To Do
For more information on what to do when you have a heart attack, see the "Act in Time" page at the National Heart, Lung and Blood Institute Web site. For more on the importance of using 911, visit the American Heart Association online.
And to learn about symptoms to watch for, go to the Heart Information Network.