Prehospital delay with myocardial infarction: The interactive effect of clinical symptoms and race

This study examined prehospital delays and clinical symptoms of myocardial infarction (MI) in blacks and whites and the relationship between longer de lays and types of clinical symptoms. The convenience sample included 128 pa tients, admitted consecutively, with acute MI. Data on types of clinical sy mptoms of MI and treatment-seeking behavior were collected on day 2 or 3 af ter admission, using face-to-face semistructured interviews. The total mean delay time differed significantly between blacks and whites (16 hours vs. 8.8 hours, p <.05). Although the frequency of chest pain was similar in bot h blacks and whites (78% vs. 77%), more than twice as many blades as whites presented with symptoms of dyspnea (56% vs. 24%, p <.01) and fatigue (32% vs. 17%, p <.05). There was an interactive effect of race-ethnicity and typ es of symptoms on delay (p <.05) was present. Delay times for whites with c hest pain were shorter than for whites without chest pain. Delay times for blacks with dyspnea were significantly shorter than for blacks without dysp nea, although delay times did not differ between whites with and without dy spnea. Copyright (C) 2000 by W.B. Saunders Company.