DISTINGUISHING BETWEEN EARLY AND LATE RESPONDERS TO SYMPTOMS OF ACUTEMYOCARDIAL-INFARCTION

The present study identified factors that distinguish early responders (i.e., requested medical assistance <60 minutes after the onset of ac ute myocardial infarction [AMI] symptoms) from late responders (i.e., request made greater than or equal to 60 minutes after symptom onset). A questionnaire developed to assess demographic characteristics, cont extual factors, antecedents to symptom onset, and behavioral, affectiv e, and cognitive responses was administered in the hospital to 501 pat ients with documented AMI, Patients who believed that their symptoms w ere cardiac in nature were more likely to be early responders, whereas patients who attributed their symptoms to indigestion, muscle pain, f atigue, or another cause responded later (p <0.0009), Early responders believed their symptoms to be more serious (p <0.0001), felt more com fortable seeking medical assistance (p <0.0001), were more anxious or upset when they first noticed symptoms (p = 0.0118), and perceived tha t they had less control of their symptoms (p <0.0001) than late respon ders, A stepwise multiple regression analysis further suggested that u nmarried patients responded significantly later than married patients, and patients who first experienced their symptoms at work responded s ignificantly later than those who first experienced their symptoms out side of the home but not at work, These results suggest that situation al and psychological variables are important determinants of lengthy d ecision delays in responding to symptoms of AMI.