Patients' interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction.
OBJECTIVE
To examine whether the association between expected symptoms of acute myocardial infarction and actual symptoms predicted delay in reaching hospital and help seeking behaviour.


METHODS
During hospital convalescence, participants completed a structured interview designed to measure symptom experience and help seeking behaviour following the onset of symptoms of acute myocardial infarction.


METHODS
88 patients admitted to hospital with their first myocardial infarction


METHODS
Delay in reaching hospital from onset of worst symptoms, obtained from ambulance and hospital records.


RESULTS
The most common symptoms expected by patients with myocardial infarction were central chest pain (76%), radiating arm or shoulder pain (34%), and collapse (26%). The most common symptoms experienced were sweats or feeling feverish (78%), chest pain (64%), and arm, shoulder, or radiating pain (66%). A mismatch between symptoms experienced and those expected occurred in 58% of patients, and was associated with delay. Patients who experienced a mismatch between expectation and actual symptoms also were more likely to have a third party decide to call for help.


CONCLUSIONS
The experience and interpretation of symptoms is an important source of delay and help seeking following onset of myocardial infarction symptoms.
Horne
R
R
Centre for Health Care Research, University of Brighton, Falmer Campus, Brighton BN1 9PH, UK. r.horne@brighton.ac.uk
James
D
D
Petrie
K
K
Weinman
J
J
Vincent
R
R
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D001294:Attitude to Health; D004739:England; D005260:Female; D015438:Health Behavior; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D010342:Patient Acceptance of Health Care; D013997:Time Factors