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NHLBI Launches Heart Attack Campaign

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Each year, about 1.1 million Americans suffer a heart attack.

About 460,000 of those heart attacks are fatal, and for nearly half, death occurs within the first hour of the start of symptoms and before the patient reaches the hospital. Yet, fast treatment can save lives and heart muscle.


Research shows that the main reason for not getting to the hospital quickly is patient delay. Most patients wait 2 or more hours before seeking emergency care — some wait as long as a day or more.

To increase Americans' awareness of the need to act fast, the National Heart, Lung, and Blood Institute has launched a special campaign called "Act in Time to Heart Attack Signs." Partners in the campaign are the American Heart Association, the American Red Cross and the National Council on the Aging.

The campaign officially began on Sept. 11 (9-1-1 Day), chosen to stress the need for Americans to call 9-1-1 when a heart attack happens in order to get to the hospital quickly. NHLBI director Dr. Claude Lenfant, AHA president Dr. David Faxon, and others announced the campaign at a press conference, held the day before at the National Press Club in Washington, D.C. They also unveiled some of the campaign's special education materials for patients and physicians, including a new web page about heart attack, which can be reached at Speakers at the press conference also included a heart attack patient from Pikesville, Md., and Dr. Bruce MacLeod, chairman of the department of emergency medicine at Mercy Hospital in Pittsburgh.

Getting physicians to talk to their patients about heart attack risk, warning signs and how to plan for an emergency is a key part of the new campaign. Lenfant and Faxon hope to reach physicians with a "call to action" published in the Sept. 11 issue of Circulation: the Journal of the American Heart Association. The editorial notes that "physicians can and should play a pivotal role in encouraging patients to have a plan of action" and that such discussions can "go a long way toward saving hearts and, thereby, saving lives."

Lenfant and Faxon also write that, in one study, fewer than 10 percent of heart attack patients said they'd ever spoken with a doctor about what to do in case of a heart attack. In the same study, about half of patients recovering in the hospital reported talking to a health professional about recognizing and responding quickly to a future heart attack.

"Our goal is to save lives by increasing the woefully low number of heart attack patients who are treated within the first hour of experiencing symptoms," said Lenfant. "It is during that crucial 60-minute window that clot-busting medication and other treatments are most effective. Unfortunately, only about 3 to 11 percent of heart attack patients are treated in that first hour."

Among the reasons why patients wait before seeking help are a lack of recognition of symptoms. The call to action notes that this is due partly to the mistaken belief that heart attacks occur suddenly, as a crushing chest pain — the "Hollywood heart attack."

"The reality," said Faxon, "is that many heart attacks are much 'quieter,' causing only mild pain or discomfort."

Other reasons for delay in seeking medical help are fear of embarrassment if the problem turns out to be a false alarm and worry about bothering others. Studies show that women, in particular, are likely to delay in seeking medical care.

The heart attack warning signs are pain or discomfort in the center of the chest; discomfort in the arms, back, neck, jaw, or stomach; shortness of breath; breaking out in a cold sweat; nausea; and light-headedness. The most common warning sign — chest discomfort — is the same for men and women. However, women are somewhat more likely than men to have some of the other common symptoms, particularly shortness of breath, nausea and vomiting, and back or jaw pain. Also, women tend to be about 10 years older than men when they have a heart attack and to have other conditions as well such as diabetes, high blood pressure and congestive heart failure.

Those who feel heart attack symptoms or notice the warning signs in others should call 9-1-1 at once. The campaign urges Americans to wait no more than a few minutes — 5 at most — before calling for emergency medical help.

"Above all, do not drive yourself to the hospital," said Lenfant. "Calling 9-1-1 is like bringing the hospital to you. Emergency medical personnel can begin treating you right away, and they have equipment that can restart your heart if it stops beating. Also, heart attack patients who take the ambulance tend to receive faster treatment on their arrival at the hospital."

The campaign includes information based on materials developed by the Rapid Early Action for Coronary Treatment (REACT) research program. Funded by NHLBI, the 4-year, multi-center REACT program tested ways to increase awareness of the need to act fast to heart attack symptoms.

National 9-1-1 Day was initiated by the National Emergency Number Association to highlight the importance of calling for emergency medical help.

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