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Why Are Doctors Failing to Notice Early Warning Signs of Heart Attack?

   |  Updated: March 02, 2017 13:13 IST

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Why Are Doctors Failing to Notice Early Warning Signs of Heart Attack?
Heart attacks occur when the flow of oxygen-rich blood does not reach the sections of the heart. If the blood flow is not restored the heart begins to die. A heart attack often occurs as a result of coronary heart disease. Another cause of heart attack is severe tightening of the arteries. Symptoms include breakout of cold sweat, feeling tired for no reason, nausea, vomiting, dizziness, etc, which may vary from person to person. Not all heart attacks begin with a sudden severe chest pain as you might have seen in the cinema. Sometimes you may not even realise that the symptoms you had were of a heart attack.

You should be aware of the heart attack symptoms and act immediately to save your life and damages to your heart. Heart ailments have become the leading cause of the increasing mortality rate across the globe. Another shocking part is that there are several cases where even the doctors fail to predict the risk of fatal heart attack in patients, causing death.



According to a study which was conducted on all heart attack hospital admissions and deaths in England, it stated that heart attack symptoms were missed in many patients by medical experts. In most cases, the patients who are admitted do not have heart problem as the main issue. It is more of a secondary problem, and as such the experts miss out on the possible warning signs.



In the United Kingdom, heart attack is the main cause of mortality rate. According to British Heart Foundation, every three minutes there is one hospital visit due to heart attacks.

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The researchers from Imperial College examined records of all 446,744 NHS hospital admissions in England between the years 2006 and 2010 that recorded heart attacks, as well as the hospitalisation history of all 135,950 heart attack death. It was recorded whether or not patients who died of a heart attack had been admitted to hospital in the past four weeks and if the signs of heart attack were recorded as the main cause of admission (primary diagnosis), additional to the main reason (secondary diagnosis), or not recorded at all.



It was concluded that of the 135,950 who died of heart attack, half of them died without the hospital admission in the prior four weeks and others died within the four weeks in hospital. 21,677 of the patients who died from heart attack had been hospitalised during the four weeks prior, but there was no mention of hospital symptoms in the hospital records.



The authors said there were certain symptoms like fainting, shortness of breath and chest pain that were apparent up to a month before death in some of these patients, but doctors were not cautious of the possibility that these might lead to an upcoming fatal heart attack because there was no obvious damage to the heart at the time.

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The researchers also found that of all the patients who were admitted with a heart attack, those who were admitted with heart attack being the secondary to the main condition were two to three times more prone to die than patients whose records stated heart attack as the main condition.

Lead author Dr Perviz Asaria, from the School of Public Health at Imperial, said: "Doctors are very good at treating heart attacks when they are the main cause of admission, but we don't do very well treating secondary heart attacks or at picking up subtle signs which might point to a heart attack death in the near future."



"Unfortunately in the four weeks following a hospital stay, nearly as many heart attack deaths occur in people for whom heart attack is not recorded as a primary cause, as occur after an admission for heart attack."



The authors said that more detailed investigation must be conducted to identify reasons so as to prevent deaths from heart attacks.



Co-author Professor Majid Ezzati, also from Imperial's School of Public Health, said: "We cannot yet say why these signs are being missed, which is why more detailed research must be conducted to make recommendations for change. This might include updated guidance for healthcare professionals, changes in clinical culture, or allowing doctors more time to examine patients and look at their previous records."



This research was published in The Lancet Public Health.



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