Up to one in six people who died of a heart attack in English hospitals may have had early warning signs missed, a new study suggests. Researchers from Imperial College London analysed all heart attack admissions and deaths between 2006 and 2010, finding that 16% of those who died had been admitted to hospital in the previous 28 days, some with symptoms like chest pain.
The study, published in The Lancet, examined hospital records of all 135,950 heart attack deaths in England over four years. It found that 21,677 patients had no mention of heart attack symptoms in their records. Lead author Dr Perviz Asaria 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.'
Alison Fillingham, 49, a homecare nurse from Lancashire, experienced a deep ache in her neck and collarbone while at work. Despite being a nurse for 24 years, she did not suspect a heart attack because her symptoms were not typical. She was initially diagnosed with a panic attack, but blood tests later revealed she had suffered a heart attack. She said: 'If my heart attack hadn't been picked up in hospital, the artery would have blocked completely and I wouldn't be here now.'
The British Heart Foundation called the research 'concerning'. Prof Jeremy Pearson, associate medical director, said: 'This failure to detect warning signs is concerning and these results should prompt doctors to be more vigilant, reducing the chance that symptoms are missed, ultimately saving more lives.' The Royal College of Physicians added that while heart attack treatment is a success story, there are still areas where care can be improved.
Symptoms such as fainting, shortness of breath and chest pain were apparent up to a month before death in some patients, but doctors may not have linked them to an approaching fatal heart attack. Prof Majid Ezzati, a co-author, 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.'
