MedWire News: Many patients with a history of heart disease have poor knowledge of heart attack symptoms and do realise that they face an increased risk of such 'events', researchers warn.

Dr Kathleen Dracup, from the University of California in San Francisco, USA, and colleagues explain that people with heart disease are up to seven times more likely to die of a heart attack than the general population.

They say that people who have suffered a heart attack have the greatest chance of surviving if they receive treatment within 1 hour of the onset of symptoms, such as pain in the chest or left arm, nausea and loss of balance and consciousness.

However, the team adds that most patients suffering a heart attack are admitted to hospital 2.5 to 3.0 hours after the start of symptoms, possibly because they did not recognise symptoms of the condition.

To assess patients' knowledge of heart attack symptoms, the researchers surveyed 3522 patients, aged an average of 67 years, who had a history of heart disease or previous heart attacks.

All the patients were asked to identify possible heart attack symptoms and answered true-false questions about heart disease. The participants were also asked whether they thought they were more or less likely to have a heart attack in the next 5 years than other people of their own age.

Poor knowledge of heart attack symptoms and heart disease was indicated by a score of less than 70% on the questionnaire.

The researchers found that, despite their history of cardiovascular problems, 44% of the patients had low knowledge levels of heart attack symptoms and heart disease.

Furthermore, 43% of participants assessed their risk of heart attacks to be the same as or lower than that of other people of the same age.

Dr Dracup and team comment: "Even following diagnosis of acute coronary syndromes [such as heart attacks] and numerous interactions with physicians and other health care professionals, knowledge about acute coronary syndrome symptoms and treatment on the part of patients with cardiac disease remains poor."

They add: "Our findings suggest that men, elderly individuals, those with low levels of education, and those who have not attended a cardiac rehabilitation programme are more likely to require special efforts during medical office visits to review symptoms of [heart attacks] and to learn the appropriate actions to take in the face of new symptoms of acute coronary syndromes."

The research is published in the Archives of Internal Medicine.