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Seeing It Coming

Tom Gilbert

March 17, 2008

Although many of us know one or two of the warning signs of heart attack, few Americans know all the symptoms or have a clear idea of what to do about them.

According to a new study by the Centers for Disease Control (CDC), only 27% of adults recognized all heart attack warning signs and would call emergency services if they suspected someone were having a heart attack or stroke. The 14-state survey was published in the Feb. 22 issue of the CDC Morbidity and Mortality Weekly Report.

The results were disappointing, said Daniel Lackland, Dr.P.H., of the Medical University of South Carolina in Charleston, an American Heart Association spokesperson.

"It was a little bit surprising in view of the huge amount of effort that many of the different agencies, including the AHA, the CDC, and the National Institutes of Health, have put into trying to increase awareness," he said.

The findings came from the CDC's Behavioral Risk Factor Surveillance System survey, an annual telephone survey that included 71,994 respondents from 13 states and the District of Columbia. Only about half of those contacted completed the survey.

Most respondees were aware of at least one of the five heart attack warning signs. The percentages that could identify each was as follows:
  • 48% for pain or discomfort in the jaw, neck or back
  • 62% for feeling weak, lightheaded or faint
  • 92% for chest pain or discomfort
  • 85% for pain or discomfort in the arms or shoulder
  • 93% for shortness of breath
However, only 31% of adults could identify all five. And when respondents were asked what action they would take first if they thought a person was having a heart attack or stroke, only 86% said they would call 911. The rates were even lower in certain subpopulations.

For awareness of all five heart attack warning signs and willingness to call 911, the rates were significantly lower among blacks, Hispanics, men and adults with less than a high school education.

Disturbingly, these are the same groups that are at the highest risk for a heart attack. "We probably should target these high risk groups," Dr. Lackland said. Among the states studied, West Virginia had the highest proportion that could identify all heart attack symptoms and would call for emergency assistance (35.5%). The District of Columbia had the lowest (16.0%).

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