Missed opportunities to impact fast response to AMI symptoms

The potential for reducing cardiovascular disease mortality rates lies both in prevention and treatment. The earlier treatment is administered, the gr eater the benefit. Thus, duration of time from onset of symptoms of acute m yocardial infarction to administration of treatment is important. One major factor contributing to failure to receive efficacious therapy is the delay time from acute myocardial infarction (AMI) symptom onset to hospital arri val. This paper examines the relationship of several factors with regard to intentions to seek care promptly for symptoms of AMI. A random-digit diale d telephone survey (n = 1294) was conducted in 20 communities located in 10 states. People who said they would wait until they were very sure that sym ptoms were a heart attack were older, reported their insurance did not pay for ambulance services, and reported less confidence in knowing signs and s ymptoms in themselves. When acknowledging symptoms of a heart attack, Afric an-Americans and people with more than a high school education reported int ention to act quickly. No measures of personal health history, nor interact ion with primary care physicians or cardiologists were significantly relate d to intention to act fast. The study confirms the importance of attributio n and perceived self-confidence in symptom recognition in care seeking. The lack of significant role of health history (i.e. those with chronic condit ions or risk factors) and clinician contact highlights missed opportunities for health care providers to educate and encourage patients about their ri sk and appropriate action. (C) 2000 Elsevier Science Ireland Ltd. All right s reserved.