Declining Recognition of Chest Pain as a Cardiac Symptom Should Act as a Shot in The Arm

Early treatment of heart attack has always been important, but even more so in the current “reperfusion era”, where management is driven by overwhelming evidence that survival and heart damage after coronary occlusion depend on how quickly the blocked coronary artery can be re-opened. Since most of the delay in treatment is pre-hospital and patient-related, there have been many efforts to reduce delay with public awareness campaigns. Most were unsuccessful [ [1] Moser D.K. Kimble L.P. Alberts M.J. Alonzo A. Croft J.B. Dracup K. et al. American Heart Association Council on Cardiovascular Nursing and Stroke Council. Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation. 2006; 114: 168-182 Crossref PubMed Scopus (477) Google Scholar ] and early campaigns sponsored by the Heart Foundation in Australia during the 1990s [ [2] Bett N. Aroney G. Thompson P. Impact of a national educational campaign to reduce patient delay in possible heart attack. Aust N Z J Med. 1993; 23: 157-161 Crossref Scopus (66) Google Scholar ] and early 2000s were no exception [ [3] Bett J.H. Tonkin A.M. Thompson P.L. Aroney C.N. Failure of current public educational campaigns to impact on the initial response of patients with possible heart attack. Intern Med J. 2005; 35: 279-282 Crossref PubMed Scopus (26) Google Scholar ]. In 2007, the Heart Foundation commissioned a detailed systematic review of previous efforts seeking recommendations for a new approach [ [4] Finn J.C. Bett J.H. Shilton T.R. Cunningham C. Thompson P.L. National Heart Foundation of Australia Chest Pain Every Minute Counts Working Group. Patient delay in responding to symptoms of possible heart attack: can we reduce time to care?. Med J Aust. 2007; 187: 293-298 Crossref PubMed Scopus (53) Google Scholar ]. The review concluded that further fact-based, short-term, non-targeted campaigns were unlikely to be successful and should not be repeated. It recommended addressing the psychosocial and behavioural blocks to action, that campaigns should be ongoing rather than short term and focus on people at highest risk. Declining Public Awareness of Heart Attack Warning Symptoms in the Years Following an Australian Public Awareness Campaign: A Cross-Sectional StudyHeart, Lung and CirculationVol. 32Issue 4PreviewThe National Heart Foundation of Australia’s (NHFA) Warning Signs campaign ran between 2010 and 2013. This study examines trends in Australian adults’ ability to name heart attack symptoms during the campaign and in the years following. Full-Text PDF Open Access