Patients who have had a cardiac event may not know the warning signs of heart disease or see themselves as being at cardiac risk, reports a recent study. A total of 3,522 patients with documented ischemic heart disease (mean age, 67 years; 68% male), and therefore at high risk for a future cardiac event, answered questions posed to them by RNs using a structured questionnaire. Nearly half (44%) demonstrated a limited knowledge of acute coronary syndrome (ACS) symptoms and risk factors for future cardiac events. Respondents with higher knowledge scores were typically women (73% vs. 70% for men; mean score was 71%) and were younger than age 70 and had higher levels of education; they were also more likely to have attended a cardiac rehabilitation program and to have been treated by a cardiologist.

Although all the patients in this study had previous heart disease, their history was not a significant predictor in determining their knowledge of ACS symptoms. Moreover, their perception of personal risk for future cardiac events was lower than expected; 43% incorrectly assessed their risk as less than or the same as other people their age. The study showed that patients' lack of knowledge of the warning signs of ACS, and their perception that they are at low risk for future heart attacks, may contribute to their tendency to delay responding to cardiac symptoms. Lead researcher Kathleen Dracup said, "Patients with heart disease need to hear the message about seeking immediate care for ACS symptoms many times and from multiple caregivers. It's truly a matter of life and death."