Concern over heart attack 999 calls
Updated on 06 July 2007
Patients at high risk of a heart attack are unsure when to dial 999, specialists warned.
People can be confused over whether their chest pains equal an attack and advice from doctors varies, a group of heart experts said.
The problem can be made worse by the use of sprays (glyceryl trinitrate or GTN sprays) to relieve angina, with some patients unable to distinguish between their angina and a heart attack.
At least 70% of people who die from coronary heart disease have had previous heart problems.
Writing in the British Medical Journal (BMJ), the authors said: "Ideally, patients would be able to distinguish stable angina from a potentially life-threatening acute coronary syndrome, but in reality they do not."
The authors examined British Heart Foundation advice for patients with known ischaemic heart disease, which causes a reduction in the blood supply to the heart, usually felt as angina.
The advice said chest pain lasting more than 15 minutes is probably a heart attack.
Patients are advised to use their GTN spray three times at five minute intervals before calling an ambulance, they said.
But, for some high-risk patients, waiting 15 minutes could be too long, the authors argued. One study has shown that the average time from onset of symptoms to heart attack is 10 minutes.
Manufacturers of sprays can offer different instructions - for example, recommending no more than three doses and leaving 15 minutes between treatments. The authors advise patients at high risk of an attack or with known ischaemic heart disease to carry a GTN spray at all times.
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