Heart attack victims reluctant to dial busy 111

Some heart attack sufferers are too worried about the 111 call system and overworked emergency departments to call for help, a study has found.

Researchers at Wellington Hospital's cardiac care unit found that the delays were also likely to be contributing to the number of people dying from acute coronary conditions.

Patients revealed a reluctance to call 111 when they suffered chest pain because they did not believe their condition was serious enough or felt that ambulance services were overworked.

The study in the New Zealand Medical Journal today says the consequence of such attitudes was that patients denied themselves fast access to emergency medical services considered vital to the survival of cardiac arrest patients.

The time between patients' experiencing the onset of symptoms and arriving at hospital was significantly longer than overseas, a median of three hours 41 minutes compared with two hours in Australia, America and Britain. Here, only 25 per cent of patients arrived at hospital within two hours.

This was partly blamed on New Zealanders' unwillingness to acknowledge that they could be having a heart attack.

But "media publicity of overworked emergency departments, overstretched ambulance services, and the psychological image of the ambulance as a 'lights and sirens, Rescue 111' service are unlikely to help matters," the researchers wrote.

Inappropriate management of patients with chest pain by general practitioners was also identified as a significant cause of delays.

Of the 100 patients surveyed, 46 interpreted their symptoms as a heart attack in the first five minutes.

Those who called ambulances took a median of 40 minutes to do so, while others chose to see a GP first because they were concerned that hospital and ambulance services were overworked.

Those who went to hospital directly arrived much faster (median time 72 minutes) than those who went by ambulance (180 minutes) and those who contacted a GP first (485 minutes).

The study concluded that there was a failure among GPs to understand the risks of delay in treatment for patients with acute coronary conditions.

Heart attacks kill people by either disrupting the heart's normal rhythm or creating blockages that can cause the heart muscle to die.

The first requires rapid treatment with a defibrillator to shock the heart back into rhythm. Blockages are best treated within 4-6 hours of onset.

Peter Larsen, one of the team of researchers from Wellington Hospital and Auckland and Otago universities involved in the study, said patients rather than the 111 system were to blame for the delays.

A senior lecturer at Wellington School of Medicine, Dr Larsen said New Zealanders had long been reluctant to call an ambulance, with the latest results mirroring those of a study carried out several years ago.