Thousands of heart attack victims had symptoms missed

Thousands of heart attack victims have had symptoms missed by a doctor weeks before their death, a major study has found.

One in six fatal heart attacks in England are suffered by people who have been examined in hospital less than a month before they died, but no heart attack symptoms were recorded.

The findings, which imply thousands of fatal heart attacks could have been avoided, show Britain’s doctors are still missing the early symptoms of a heart attack despite years of awareness campaigns.

Thousands of heart attack victims have had symptoms missed by a doctor weeks before their death, a major study has found (file photo)

Red flags such as chest pain, shortness of breath or nausea, if spotted, could save someone’s life.

But the Imperial College London team said doctors were not ‘alert to the possibility’ these signalled an upcoming fatal heart attack.

Some 188,000 people suffer heart attacks in Britain each year, and nearly 70,000 die as a result.

The chance of surviving is significantly increased with quick treatment.

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An initial misdiagnosis drives up the chance of dying within four weeks by 70 per cent, previous research has found.

Cardiologists warn that not enough people know the symptoms of a heart attack – and often mistake the warning signs for indigestion or muscle pain.

Many people assume that a heart attack strikes suddenly, with someone clutching their chest and keeling over.

Instead, it often happens gradually, with people typically complaining of nausea and an aching chest, jaw or arms.

As a result, doctors may incorrectly misdiagnose the symptoms as a less serious problem, such as a muscle strain or digestive problem.

The authors of the new study, published in the Lancet Public Health journal, examined records from 136,000 fatal heart attacks in England between 2006 and 2010.

Some 188,000 people suffer heart attacks in Britain each year, and nearly 70,000 die as a result

Some 21,677 – 16 per cent – of the patients had been hospitalised during the four weeks before their death, but no heart attack symptoms had been mentioned on their records.

In many patients symptoms such as fainting or shortness of breath had been apparent, but the doctors had not recognised the heart attack risk.

Lead author Dr Perviz Asaria, from the School of Public Health at Imperial, 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 which might point to a heart attack death in the near future.

‘Unfortunately in the four weeks following a hospital stay, nearly as many heart attack deaths occur in people for whom heart attack is not recorded as a primary cause, as occur after an admission for heart attack.’

The authors are now trying to work out the reasons for these results so more deaths from heart attack can be prevented.

Co-author Professor Majid Ezzati said a ‘change in clinical culture’ may be needed, and doctors allowed more time to examine patients and look at their previous records.

He said: ‘What we are now asking is, if symptoms are being missed where they could have been discovered using the available information, how should care now be organised and what changes need to be made to prevent unnecessary deaths.’

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: ‘This study shows that large numbers of people who die of a heart attack have visited hospital in the month before, but have not been diagnosed with heart disease.

‘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 and ultimately saving more lives.’