Early heart attack symptoms missed, research warns

Research conducted by Imperial College and published in the Lancet has suggested that early warning signs were missed in one in six heart attack deaths in England.

The study looked at all 135,950 heart attack hospital admissions and associated deaths between 2006 and 2010 and found 16 per cent who died of a heart attack within 28 days of an admission had not been diagnosed, despite having symptoms like chest pain.

The records showed whether the person had been admitted to hospital in the previous four weeks and whether signs of a heart attack were recorded as the primary reason for the hospital admission, with 21,677 patients having no mention of heart attack symptoms in their records.

Key symptoms associated with heart attacks include: chest pain, dizziness, sweating, shortness of breath, nausea, anxiety and coughing.

Lead author Dr Perviz Asaria said: "Doctors are very good at treating heart attacks when they are the main cause of admission, but we don't do very well treating secondary heart attacks or at picking up subtle signs which might point to a heart attack death in the near future."

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, said: "This study shows that large numbers of people who die of a heart attack have visited hospital in the month before, but have not been diagnosed with heart disease.

"This failure to detect warning signs is concerning and these results should prompt doctors to be more vigilant, reducing the chance that symptoms are missed, ultimately saving more lives."

A spokesman for the Royal College of Physicians said: "The treatment of heart attacks is one of the success stories of modern medicine but this paper is an important reminder that there are still areas where we can improve care.

"While many heart attacks present with classical pain in the chest in people who smoke and have other risk factors for heart disease, many heart attacks don't present this way and in people not obviously at high risk.

"The challenge is to accurately and speedily diagnose all these patients so that they can be offered best care. Education of the public, of GPs, paramedics and Emergency Department doctors is essential if we are to improve even further the care we offer to patients having a heart attack."