Researchers have identified a new barrier to timely care for MI patients: a perceived inability to act that leaves them immobilized and unable to seek professional help, in some cases for an excess of 24 hours.
In a paper published May 28 in the European Journal of Cardiovascular Nursing, study lead Carolin Nymark, PhD, of Karolinska University Hospital in Stockholm, and her colleagues said most MI deaths occur within the first few hours of a patient noticing their symptoms, meaning it’s imperative to act quickly on those symptoms to survive. Yet participants in Nymark et al.’s study—326 heart patients undergoing acute treatment for a first or second MI—waited an average of three hours before seeking medical help.
Study participants all filled out the PA-AMI questionnaire, a validated measure of patients’ appraisal, emotions and action tendencies during an MI. Scrutinizing the data, Nymark and colleagues found the main reasons people delayed care were either a perceived inability to act on their symptoms or inaccurate symptom appraisal.
Immobilization seemed to mostly affect patients who waited more than 12 hours to seek help. They said in the questionnaires they didn’t know what to do when they got their symptoms, and felt “paralyzed” and like they’d “lost all power to act” when MI symptoms hit.
“This immobilization during ongoing heart attack symptoms has not been shown or studied before,” Nymark said in a release. “At the moment we don’t know why some patients react in this way. It is possibly linked to fear or anxiety. This should be a novel element in educating people about what to do when they have heart attack symptoms.”
Other patients who delayed seeking care for more than 12 hours said it took them awhile to understand their symptoms and recognize them as red flags for MI, often thinking the symptoms would pass or that they weren’t serious enough to seek medical care. Nymark said some patients even justify waiting by assuming the ICU is closed in the middle of the night, “perhaps because they do not think clearly during the event.”
Nymark said feeling powerless over heart attack symptoms should be regarded as a real health threat and should be discussed in outpatient appointments and cardiac rehab programs. She said reducing patient delays is a complex task, and a key part of that will be informing patients and the public about these things.
“If you have symptoms that may be caused by a heart attack, don’t ignore them,” she said. “Call for help immediately. It is better to be wrong about the symptoms than dead.”