Patients fail to recognise heart-attack symptoms

To mark World Heart Day, doctors discuss the importance of recognising heart attack symptoms.

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DUBAI // Patients suffering heart attacks are travelling to hospital by bus, bicycle and even on foot because they fail to recognise the symptoms of the world's leading cause of death.

Lack of education on identifying heart problems - many patients mistakenly think they have heartburn or indigestion - can delay treatment and put lives at risk, doctors said yesterday.

"Our data shows that people don't use the ambulance service," said Dr Wael Abdulrahman Almahmeed, the deputy chief medical officer and head of the cardiology, heart and vascular institute at Sheikh Khalifa Medical City in Abu Dhabi.

"If somebody is having chest pains the patient should go straight to the emergency department … because the more time it takes you to go and see a physician, the more muscle can be damaged during the heart attack. Time is muscle."

Dr Khalifa Mohammed, a senior specialist in cardiology at Rashid Hospital in Dubai, said fewer than 35 per cent of heart attack patients who are labourers called an ambulance. "Some come on their bikes, some on a bus," he said. "Others will even just walk to the hospital."

Experts said it was not unusual for patients experiencing symptoms of a heart attack to call several physicians and pharmacies before going to hospital.

"Heart attack symptoms include a heavy feeling and dull pain in the chest, lightheadedness, and a shortness of breath," Dr Mohammed said.

"However, many individuals do not know they are having a heart attack."

From the moment a patient suffers a heart attack, chances of survival drop with every minute that passes without appropriate treatment.

Standards set by international institutions, such as the American Heart Association, require action to be taken within a certain period of time.

“We must master the diagnosis within 10 minutes and administer the de-clotting medication, if applicable, within 30 minutes,” Dr Mohammed said. “This is called door-to-needle time.”

In cases where a patient needs a primary angioplasty, where a small balloon is inserted into the artery and inflated to unblock it, it must be completed within 90 minutes of the heart attack.

“This is referred to as door-to-balloon time,” he said. “The type of treatment depends on how soon the heart attack occurred.”

Cardiovascular disease accounts for 22 per cent of deaths in the UAE, and patients start to exhibit symptoms far earlier in life – 10 to 15 years younger – than in the West.

In Dubai, of every 10 people who suffer a heart attack, two will die instantly and another two will die within a year as a result of compounded illnesses such as diabetes or hypertension.

According to a survey of 5,000 respondents conducted by the Dubai Health Authority (DHA) and the Dubai Statistics Centre, a quarter of the emirate’s residents have preventable risk factors such as hypertension, high cholesterol or they are smoking.

“The lack of exercise coupled with unhealthy lifestyle choices have put a significant percentage of the emirate’s population at a risk of developing cardiovascular disease,” said Laila Al Jassimi, chief executive of the health policy and strategy sector at the DHA.

Doctors also said many patients who had already suffered a heart attack failed to heed the warning and change their lifestyle.

“We find that a lot still have high blood pressure, a lot still have high cholesterol, a lot of them are still smoking, a lot are not exercising, a lot are getting fatter and a lot are not taking their medications,” Dr Almahmeed said.

“You’d think by having a heart attack you’d have learnt your lesson and take care of yourself and we find the exact opposite.”

Despite readily available first-aid training and education courses, people continued to suffer fatal heart attacks, Dr Almahmeed said.

“People who want to know more about heart disease or who want to help people should learn how to do basic life support,” he said.

“We’ve had patients dying in major restaurants, in big hotels, and not a single person knows how to do basic life support.”

The end result could be improved by such knowledge, he said.

“You could save a life until the ambulance comes along.”

The doctors were speaking to mark World Heart Day, which is today.