Second Most Common Heart Attack Symptom Is Considered 'Atypical,' May Cause More Deaths

Breathing problems and other "atypical" symptoms of heart attacks are often overlooked, resulting in a higher risk of death among patients with these symptoms compared to those who experience chest pain, according to a recent study.

A study published in the European Heart Journal – Acute Cardiovascular Care said that one in four heart attack patients experience atypical symptoms, which are considered unusual and not very common in a particular condition or diagnosis. These symptoms include extreme exhaustion or fatigue, breathing difficulties and abdominal pain.

The study found that patients with atypical symptoms were less likely to receive emergency help and have increased chances of dying within 30 days compared to those who experience the usual symptoms such as chest pain.

"We found that atypical symptoms were most common among older people, especially women, who called a non-emergency helpline for assistance," said study author Amalie Lykkemark Møller, a Ph.D. student at Nordsjællands Hospital in Hillerød, Denmark, according to a press release from the European Society of Cardiology (ESC).

"This suggests that patients were unaware that their symptoms required urgent attention," Møller continued.

Immediate care is needed to restore blood flow and reduce mortality for heart attack patients, as per ESC. To lessen the risk of dying from the condition, early detection and symptom recognition are highly crucial.

For the study, researchers studied the calls to a 24-hour medical helpline and an emergency number in the Capital Region of Denmark between 2014 and 2018. In 7,222 heart attacks, 72% had chest pain as their primary symptom, while 24% had atypical symptoms, with breathing problems being the most common.

For those who experienced chest pain, 95% and 76% received an emergency dispatch from the emergency number and medical helpline, respectively. This is much higher than the 62% and 17% for heart attack patients with atypical symptoms.

Using a standardized comparison between patients who experienced common symptoms of a heart attack and those who had atypical symptoms, the researchers found a large difference in the mortality rate between the two. The study's standardized mortality rate was 4.3% for patients with chest pain and 15.6% for those with atypical symptoms.

"Taken together, our results show that heart attack patients with chest pain were three times more likely to receive an emergency ambulance than those with other symptoms," Møller said.

"People with atypical symptoms more often called the helpline, which could indicate that their symptoms were milder, or they were not aware of the severity. Vague symptoms may contribute to health staff misinterpreting them as benign," the study author added.

These atypical symptoms were found to occur more commonly among older patients, especially women.

"Death within 30 days was more than three-fold higher in those with atypical symptoms compared to chest pain," Møller said. "This could be due to treatment delays caused by not receiving the appropriate emergency dispatch. However, it is unknown whether an increase in emergency dispatches alone would improve survival among heart attack patients with atypical symptoms - we aim to investigate this in future research projects."

It is of utmost importance to be mindful of one's symptoms and to seek medical help when needed to prevent fatal consequences.