‘Hollywood heart attacks’ put real lives at risk

Medical Tribune October 2008 P10
David Brill

Television portrayals of heart attacks are causing people to overlook real-life symptoms, a UK charity warned recently.

A survey, commissioned as part of a national campaign by the British Heart Foundation (BHF), found that four out of 10 people based their knowledge of heart attack symptoms on movies and television. However, these typically overdramatic scenes often fail to reflect the reality of the situation, the charity said.

“The classic ‘Hollywood heart attack’ – clutching the chest and falling down in pain – is generally the image that’s conjured up when people think about heart attacks but there’s a full range of symptoms that can be much more subtle,” said Mr. David Barker, head of communications at the BHF.

He added that heart attack victims often delay calling an ambulance because they don’t recognize the seriousness of their symptoms and simply wait to see if they will pass.

Just 18 percent of the 2,014 respondents in the UK survey were familiar with the signs of a heart attack and only 6 percent had discussed the matter with their GP.

The BHF campaign has been emphasizing that heart attacks vary from person to person and encouraging the public to seek prompt medical attention should they experience any symptoms. Besides classical chest pain, these include aching in the arms and jaw, sweatiness, shortness of breath and nausea, which can sometimes be dismissed as indigestion.

Dr. Aaron Wong, a senior consultant at the National Heart Centre (NHC), Singapore, called on the Singapore Heart Foundation to launch a similar public awareness campaign.

Although good progress has been made at streamlining processes within Singapore’s hospitals, there are often still significant delays in getting patients there in the first place, he said.

“The sooner we open up the [occluded] artery the less likely it is that the patient is going to die. Every 10 minutes of time saved can reduce the mortality by about 1 percent, so if you come in within an hour of a heart attack the chances of surviving are much, much higher than for those who wait for 6 or 7 hours,” he said.

Wong also urged patients to travel to hospital by ambulance so that treatment can be given en route. Some patients in the past have been diagnosed with myocardial infarction at their GP’s clinic and then dispatched to hospital in a taxi, he said.

The BHF campaign, which was endorsed by several high-profile UK figures, included a compelling 2-minute advertisement shown on national television which depicted a heart attack from the perspective of the viewer. Barker estimates that 6.5 million people – over a quarter of the total audience share – tuned in for the event.

The UK ambulance service also backed the initiative, with a spokesman saying: “We’d rather attend a false alarm than arrive too late.”

Wong estimates that the NHC sees around 600 to 800 cases of ST-segment elevation myocardial infarction per year, but said that many do not present within 12 hours of their attack and are not eligible for primary percutaneous coronary intervention (PCI).

Those who do arrive in time can now expect to receive PCI within 70 or 80 minutes, he said, acknowledging the success of initiatives to reduce door-to-balloon time. The NHC is now planning the next phase, whereby electrocardiography will be performed in the field and transmitted to the hospital in advance of the patient’s arrival, he added.