Diabetes Self-Management Blog

People having a heart attack commonly delay going to the hospital for hours from the time symptoms first appear, according to research recently published in the Archives of Internal Medicine, potentially leading to worse health outcomes. Having diabetes doubles a person’s risk of developing serious blood vessel conditions such as a heart attack or stroke.

Guidelines recommend calling 9-1-1 if a person is having heart attack symptoms (such as chest pain or discomfort, shortness of breath, and discomfort in the neck, jaw, or arms) that do not improve within five minutes. Getting prompt medical treatment is particularly important for someone having a type of heart attack known as a STEMI (ST-segment elevation myocardial infarction, named after a pattern that appears on electrocardiograms), but symptoms alone cannot tell a person whether he is having a STEMI or nonSTEMI heart attack, so urgent medical care is necessary whenever symptoms arise.

Previous studies have indicated that the average delay time between the onset of symptoms and arrival at a hospital in people having a STEMI heart attack is two hours, and that this delay negatively impacts health outcomes. To determine the impact of a delay in arriving at the hospital in people with non-STEMI heart attacks, researchers looked at 104,622 people who’d had this type of heart attack and been treated in one of 568 hospitals between 2001 and 2006.

The data showed that the median (midpoint) delay for people experiencing a non-STEMI heart attack was 2.6 hours, with roughly 60% of people arriving at the hospital more the two hours after the onset of heart attack symptoms, and with 11% of people arriving over 12 hours after the onset of symptoms. People who had diabetes, currently smoked, or who were older, female, or a race other than white were likely to have longer delays. The effect of these factors was not as significant as the overall effect of the length of the delay in getting treatment, however.

The researchers concluded, “Long delay times are common and have not changed over time for patients with non-STEMI. Because patients cannot differentiate whether symptoms are due to STEMI or non-STEMI, early presentation is desirable in both instances.”

According to the American Heart Association, symptoms of a heart attack include discomfort in the chest that lasts more than a few minutes and that can feel like pressure, squeezing, fullness, or pain; discomfort in the arms, jaw, neck, back, or stomach; or other symptoms such as shortness of breath; breaking out in a cold sweat; lightheadedness; or nausea. If you have any of these symptoms, you should immediately call 9-1-1 or your local emergency number.

To learn more about the research, see the article “Many With Heart Attack Symptoms Delay Care” or see the study’s abstract in the Archives of Internal Medicine. And for more information about what you should do if you think you may be having a heart attack, see the article “Heart Attack: Fast Action Needed.”

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