Many Delay Calling 9-1-1 in Spite of Heart Attack Symptoms

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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  • Fazil

    Possibly the BEST blog that I have read all year and sharing!….

  • Marlene Whitby

    Having experienced two heart attacks in the last 15 years I just wanted to alert the gals out there, that they may not experience any of the typical symptoms listed for a heart attack. I was 42 when I had my first attack and the only symptom I experienced was complete exhaustion, no pain, no heaviness in my chest,etc I had just been to my endocrinologist 2 days prior, had low blood pressure, cholesterol, etc. but ended up having the heart attack and a subsequent triple by pass. About 10 years later i had another attack while I was visiting out of town. That one I woke up in the middle of the night vomiting and completely nauseous. I called for an ambulance because I knew I would need some antinausea medication to stop the vomiting and I would need an IV to rehydrate me. I was really surprised when the medical staff told me I had suffered a heart attack as well. Absolutely no typical symptoms for me! I am on a medicine regimen, had an ASD device installed, and watch what I eat and get regular exercise. I have always eaten a healthy diet since I was diagnosed as diabetic at age 7, have only eaten whole grains since I was 20 and stay away from fried foods. I do take daily doses of omega 3 fish oil pills and eat lots of vegetables,fruits, and fish meals. I’m hoping that keeps me ok.

  • Cathy A.

    I had a heart attack 6 years ago at age 53. No high BP or high cholesterol. It started with a pain in the center of my chest. Felt like stress. Lasted all day, ended when I screamed at the dogs. The next morning I woke with a good portion of the symptoms: jaw pain, arm pain, nausea, sweating. BUT, I rationalized it away because of no high BP or cholesterol.

    So…I went to my haircut appt. Then I was on my way to the bank when I realized I would not be able to walk across the bank lobby. I stopped by my encrinologist’s office on the way to the bank and they did an EKG. They said I had to go to the hospital and I agreed, telling them I would drive to the local one. They said no, they would call an ambulance. I said NO, I will call my niece who lived nearby. The niece came, I got to the ER and the next thing I knew I was in surgery to put in a stent in a 100% blocked right coronary artery.

    I was close to being dead. Why? Because I was afraid I would get to the ER and they would just tell me to go home and take an antacid. I didn’t want to feel foolish, so I would rather feel dead. How stupid could I have been?

    This is a “do what I say not as I do” moment.

  • Dave

    I decided to have a stress test as I had been having more instances of shortness of breath. No pains anywhere. I arrived for my treadmill tests, they hooked up the EKG machine and the next thing I knew. I was not going to get on the treadmill, I was admitted to hospital had a heart catherization where they found 95% blockage in what they call the “widow maker” and other blockages. Next day I was transported to another hospital for triple bypass surgery. All the hype about pain et al may not be as important as LISTEN TO WHAT YOUR BODY IS TELLING YOU. Should things not feel right seek medical attention. You just never know.