Sultanate of Oman

Ministry of health
Oman College of Health Science
Bachelor of Science in Nursing Program
Muscat Branch

Awareness of heart attack among adults age 18-45

years of age in Muscat region.

SN .Reg No Students Names

1 960 Al Ghaliya Hamdan Alkalbani
2 1011 Mariya Yousuf Albalushi
3 966 Anfal Dur Mohammed Albalushi
4 984 Fida khalid Ali alruwaishdi
5 1047 Shahad Hamood Alamri
6 1063 Wisal waleed alsiyabi
7 1035 Rawan juma alabri
8 1059 Thuraiya Sami Khalaf Al-Saaidi
9 996 Hafidha Hafidh Salim Alwahaibi
10 1041 Riham Khamis Gharib Al Rahbi
11 1056 Tasnim Khalid Humaid Al Abri
12 1053 Shahad said almoharbi
13 963 Alsafaa Salim Al-Jardani
14 1026 Nawf Ahmed Al-Hadi

Supervised by: Dr. Amal Al Ghasani

 Introduction and Background

Cardiovascular diseases (CVD) are one of the leading causes of death worldwide. An
estimated 17.9 million people died of CVD in 2019, accounting for 32% of all global deaths,
85% of these deaths were due to heart attacks and strokes. The global annual number of
deaths due to cardiovascular diseases is expected to rise to more than 23 million by 2030 and
more than 34 million by 2060. While in the Sultanate of Oman, mortality rates are caused by
cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. In the age group
(30-70 years) about 131.1 per 100,000 of the population, according to the statistics of the
Ministry of Health for the year 2021.

A myocardial infarction (commonly called a heart attack) is a very serious heart disease that
occurs when the flow of oxygen-rich blood is suddenly blocked in one or more of the
coronary arteries that supply the heart muscle, and part of the heart muscle cannot get enough
oxygen. If blood flow is not quickly restored, a heart attack can cause permanent damage to
the heart and death. Everyone must not ignore even the minor heart attack symptoms.
Immediate treatment lessens heart damage and saves lives. There are many complications
associated with heart attacks include: Arrhythmias (abnormal heart rhythms), Heart failure,
Heart valve problems, Sudden cardiac arrest, Depression and anxiety. Mechanical
complications of a heart attack, such as a ventricular septal defect or free wall rupture. These
are more likely to happen with delayed treatment of a heart attack. Many health conditions
such as diabetes, high blood pressure, lifestyle, age and family history can increase the risk of
heart disease and heart attack. Most cardiovascular diseases can be prevented by addressing
behavioral risk factors such as tobacco use, unhealthy diet, obesity, and physical inactivity.

Heart attack occurs for the elderly as well as for adults, as studies reveal that heart attacks
affect those under the age of 40, according to research presented at the 68th Annual Scientific
Session of the American College of Cardiology. The percentage of young adults who suffer a
heart attack increased by 2 in cent each year for the past ten years. Increasing people's
awareness is one of the most important roles in reducing heart attacks for different age
groups. Blankstein said: (Many people believe that a heart attack is doomed to occur, but the
vast majority can be prevented through early detection of the disease, aggressive changes in
lifestyle and management of other risk factors.)
Heart attacks, which increase in the winter season compared to the rest of the year, are the
leading cause of death for about 18 million people each year, accounting for 31% of all
deaths. Many acute heart attacks typically happen between five and nine in the morning
because of the biological clock in the human body, when levels of the hormones cortisone
and adrenaline are at their highest .[Yousef Salim., 2022]

Worldwide, the cases of heart attacks are increasing especially after the COVID-19 Pandemic
and according to the Researchers discovered that overall heart attacks increased for all age
groups since the onset of the pandemic by 14 percent. By the second year of the pandemic
[2022], heart attacks for the 45-64 age group increased by 19.6% and for the 65 and older
group had increased by 13.7%. However, it was the youngest age group [25-44] that had the
highest increase of nearly 30%. [Harjo-Livingston, S., 2023]

Nowadays, heart attack become a huge problem in Oman especially among young adults and
this approved by the Senior Consultant Cardiologist at Sultan Qaboos University, who said
that according to international data, the number of people under the age of 40 who have a
heart attack has increased by 2% annually over the past ten years. This rise is attributed to
modern lifestyle changes and an increase in idle behavior, particularly since the start of the
curfew and closures caused by the Corona pandemic. and it comes at the top of the list of risk
factors that can increase the chances of a heart attack in young people; Smoking and
excessive use of tobacco, high cholesterol levels, diabetes mellitus, in addition to a sedentary
lifestyle, poor diet, stress and depression, family history or genetic risk, obesity and high BMI
levels, drug use.
 Problem statement and it's significant

According to a new study, a heart attack (myocardial infarction, or MI) is a critical medical
emergency in which the blood supply to the heart is suddenly interrupted, typically by a
blood clot (NHS website, 2022). Heart attack symptoms can include chest pain or discomfort,
as well as pain or discomfort in the arms, left shoulder, elbows, jaw, or back. [WHO,2021]

Heart attack reports among adults between the ages of 18 and 20 have increased over the
course of the last few years, reflecting an increase in the occurrence. Global statistics
indicates that during the past ten years, the number of adults under the age of 40 who
experience a heart attack has increased by 2% annually. Additionally, cardiologists at the
Cleveland Clinic Hospital in the United States said that there was an urgent need to increase
awareness of heart attacks in the region. The Gulf nations were the location of the Cleveland
Clinic survey. The two most common signs of a heart attack are "shortness of breath" and "a
sense of pressure, squeezing, heaviness, or pain in the center of the chest. "More than 70% of
the survey participants, in just two countries, were able to correctly identify chest pain as a
symptom of a heart attack; And that in Bahrain by 74% and in Oman by 73%. [Kennisgeving
Voor Omleiding, 2018]

Additionally, doctors in the United Arab Emirates have expressed concern about a surge in
the number of young individuals suffering from cardiovascular illness, with half of those
affected by heart attacks under the age of 50. It turns out that cardiovascular disease (CVD)
accounts for 40% of all deaths in the United Arab Emirates and is a major cause of death
globally. [Al Arabiya English, 2021]

Purpose:

This project aims to increase community awareness regarding heart attacks and their related
complications and consequences.

Objectives:

» To Assess the level of awareness about heart attack

» To minimize risk factors of a heart attack.
» To prevent complications of a heart attack.
» To Educate the community about signs and symptoms of heart attack
 Literature review

Evidence no.1
Knowledge and poor understanding factors of stroke and heart attack symptoms.

Chang Hoon Hanetal conduct a study about knowledge and poor understanding of factors
related to stroke and heart attack symptoms in South korea. This study aims to assess general
community awareness of heart attack and stroke symptoms and identify the risk factors for
inadequate understanding of cardiovascular illness. They gathered information from the
disease prevention and control centers in Korea. This cross-sectional study included 228,240
people who took part in the 2017 Korean Community Health Survey. Data on
sociodemographic traits and awareness of CVD event warnings indicates were examined .
Investigating factors linked to inadequate knowledge of CVD was done using logistic
regression analysis. A two stage sampling technique is employed by the national cross
sectional KCHS. First, primary sampling units are chosen using a probabilistic method based
on the number of homes in distinct South Korean regions. Then, in each sampling region,
households are carefully chosen for examination. This two-stage sampling procedure ensures
that the results are representative of the total population of South Korea. According to the
study's findings, 19.0% of participants had poor CVD knowledge scores, with men
performing worse than women. Significant correlations were found between a poor
understanding of CVD warning signs and older age, male gender, lower education level, lack
of regular exercise, single status, unemployment, and low socioeconomic status. Finally. The
study's findings suggest that the general South Korean population's knowledge of CVD has to
be improved. Less knowledge of CVD has to be emphasized in public health education.

Citation Ahmed AAA, Al-Shami AM, Jamshed S, Zawiah M, Elnaem MH, Mohamed Ibrahim MI. Awareness
of the Risk Factors for Heart Attack Among the General Public in Pahang, Malaysia: A Cross-
Sectional Study. Risk Manag Healthc Policy. 2020 Dec 23
Purpose This study aims to assess general community awareness of heart attack and stroke symptoms and
identify the risk factors for inadequate understanding of cardiovascular illness
Sample 228,240 adults (102,408 males, 125,832 females)
Design Cross sectional study
Measure Data on sociodemographic traits and awareness of CVD event warnings indicates were examined .
ment Investigating factors linked to inadequate knowledge of CVD was done using logistic regression
analysis
Result According to the study's findings, 19.0% of participants had poor CVD knowledge scores, with men
 performing worse than women. Significant correlations were found between a poor understanding of
CVD warning signs and older age, male gender, lower education level, lack of regular exercise, single
status, unemployment, and low socioeconomic status

Evidence no.2
Knowledge and Attitude of General People Towards Symptoms of Heart Attack and
the Impact of Delay Time in Riyadh, Saudi Arabia

A study was done in Riyadh ,Saudi Arabia , in 2022. The goal of the study was to evaluate
the general public's understanding of heart attack early symptoms and risk factors in Riyadh,
the capital of Saudi Arabia . By educating people and promoting a healthy lifestyle, we can
reduce the burden of the disease, as well as the mortality rate, and prevent risk, as well as
give an idea about the common presentation for patients with cardiac events and the effect
of delay time on the patients. The method used is a one year cross sectional study from July
2021 to July 2022 conducted among 385 individuals in Riyadh , Saudi Arabia . The most
prevalent heart attack symptom, according to participant knowledge, was chest discomfort or
pressure (80.5%), followed by shortness of breath (77%) and weakness and exhaustion
(72.0%). The participants also knew that smoking and obesity were 90.2% and 90.7%risk
factors for heart attacks , respectively. They discovered that men were more likely than
women to have limited knowledge, with 46% of participants saying they "would not be at all
certain" of detecting the symptoms and indicators of a heart attack in another person and
45.7% saying "in themselves." To summarize, this study indicates that people are not aware
of the symptoms and indicators of a heart attack. The findings of this study can be viewed as
a first step in the direction of providing fundamental knowledge on the level of awareness
regarding heart attacks and associated risk factors among the general population in Riyadh,
Saudi Arabia. 

Citation Al Harbi KM, Alluhidan WA, Almatroudi MI, Almuhanna NI, Alotaibi NM. Knowledge and Attitude
of General People Towards Symptoms of Heart Attack and the Impact of Delay Time in Riyadh, Saudi
Arabia. Cureus. 2022 Dec 20
Purpose This study aims to assess public understanding of heart attack symptoms and risk factors in Riyadh,
Saudi Arabia.
Sample Riyadh population: Approximately 8million.
Sample size: 385 completed questionnaires. Confidence level: 95%. The margin of error is 5%.
Inclusion criteria / Adults older than 18 years living in Riyadh, Saudi Arabia. English or Arabic
speakers.
Exclusion criteria/ Adults with mental diseases, those under the age of 18, those residing outside of
Riyadh, and speakers of languages other than Arabic or English.
Design A cross-sectional study including 385 individuals was carried out in Riyadh, Saudi Arabia, from July
2021 to July 2022.
Measure they used the Acute Coronary Syndrome Response Index, with additional questions added, such as risk
ment factors of heart attack and physical activity time. An anonymous self-administered online questionnaire
was used to collect the data
Result The most prevalent heart attack symptom, according to participant knowledge, was chest discomfort or
pressure (80.5%), followed by shortness of breath (77%) and weakness and exhaustion (72.0%). The
participants also knew that smoking and obesity were 90.2% and 90.7%risk factors for heart attacks ,
respectively. They discovered that men were more likely than women to have limited knowledge, with
46% of participants saying they "would not be at all certain" of detecting the symptoms and indicators
of a heart attack in another person and 45.7% saying "in themselves.

Evidence no.3
Public knowledge of cardiovascular disease and response to acute cardiac events in
three municipalities in Brazil.

A study was done in Brazil in 2020. Which aims to conduct a landscape assessment of public
knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms,
cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness
and training in three underserved communities. A cross-sectional, population-based survey of
non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern
Brazil. Data were analysed as survey-weighted percentages of the sampled populations. 3035
surveys were completed. Overall, one-third of respondents was unable to identify at least one
cardiovascular disease risk factor and 25% unable to identify at least one myocardial
infarction symptom. A minority of respondents had received training in CPR or were able to
identify an AED. Low levels of education and low socioeconomic status were consistent
predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary
syndrome symptoms and CPR and AED use. In three municipalities in Eastern Brazil, overall
public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge
of appropriate CPR and AED use was low. The findings indicate the need for interventions to
improve public knowledge and response to acute cardiovascular events in Brazil as a first
 step towards improving health outcomes in this population. Significant heterogeneity in
knowledge seen across sites and socioeconomic strata indicates a need to appropriately target
such interventions.

Citation Bartlett ES, Flor LS, Medeiros DS, Colombara DV, Johanns CK, Camargo Vaz FA, Wilson S, Duber
HC. Public knowledge of cardiovascular disease and response to acute cardiac events in three
municipalities in Brazil. Open Heart. 2020 Aug

Purpose To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and
acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external
defibrillator (AED) awareness and training in three underserved communities in Brazil.
Sample The study aimed to survey 962 individuals in PP, 1109 in PC and 1054 in VDC
Design Cross sectional study
Measure Data were analysed as survey-weighted percentages of the sampled populations.
ment
Result According to the study's findings, one-third of respondents was unable to identify at least one
cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction
symptom. A minority of respondents had received training in CPR or were able to identify an AED.
Low levels of education and low socioeconomic status were consistent predictors of lower knowledge
levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED
use.
 Evidence no.4
Public awareness of early symptoms of acute myocardial infarction among Saudi
population.

Study was done in Saudi Arabia in 2021. The main objective is to gauge the local public
awareness of the early symptoms of MI, and their knowledge of the best course of action to
be taken from the onset of symptoms. The method of research was a cross-sectional study
was conducted using google forms. Participants were randomly selected through multiple
social media platforms. The study included Saudi citizens who were 18 years or older, with
no current or prior experience in the health care field. The questionnaire assessed the
participants' awareness of 14 risk factors for CAD. The results showed A total of 1689
participants were involved in this study. Sixty percent were females, and 29.2% were in the
age group of 18–24 years. Seventy-three percent of the participants knew the definition of
heart attack, and 90% knew that chest pain is a symptom of a heart attack. Approximately,
75% of the participants recognized that hypertension, cigarette smoking, and high cholesterol
are the risk factors of MI. In terms of knowledge, Al Madinah province obtained the highest
score when compared with other regions.

Citation Basham, K., Aldubaikhi, A., Sulaiman, I., Alhaider, A., Alrasheed, A., Bahanan, F., Masuadi, E.,
& Alsaif, A. (2021, January 1). Directory of open access journals. Journal of Family Medicine
and Primary Care. Retrieved February 3, 2023, from
https://doaj.org/article/132130c89f554ac58b63e858032a303f
Purpose To gauge the local public awareness of the early symptoms of MI, and their knowledge of the best
course of action to be taken from the onset of symptoms.
Sample The study included Saudi citizens who were 18 years or older, total of 1689 participants were
randomly selected through multiple social media platforms.
Design Cross sectional study
Measure The data were analyzed by a survey using google form that include questionnaire .
ment
Result  A total of 1689 participants were involved in this study. Sixty percent were females, and 29.2% were
in the age group of 18–24 years. Seventy-three percent of the participants knew the definition
of heart attack, and 90% knew that chest pain is a symptom of a heart attack. Approximately, 75% of
the participants recognized that hypertension, cigarette smoking, and high cholesterol are the risk
factors of MI.
 Evidence no.5
Awareness of the Risk Factors for Heart Attack Among the General Public in Pahang,
Malaysia: A Cross-Sectional Study

A study was done in Pahang, Malaysia which aims to assess the awareness of risk factors for
heart attack and to identify the factors associated with the awareness of all modifiable risk
factors for heart attack in the general population. It is a cross-sectional study, it was
conducted among 393 adult individuals in Kuantan, Pahang, Malaysia. Data collection was
conducted through face-to-face interviews among the lay public members who were 18-64
years old, excluding healthcare professionals in clinical settings and academic settings.
Statistical analysis was performed using chi-square test and logistic regression analysis. The
result was the majority of the individuals identified smoking as a risk factor for heart attack,
followed by atrial fibrillation (57.7%), heart disease (54.1%), and obesity (53.8%). However,
diabetes (26%) was the risk factor that was least recognized by the participants. A total of
90.6% of participants identified at least one risk factor for heart attack, while 9.8% of the
participants did not identify any risk factors for heart attack, whereas 5.6% identified all
modifiable heart attack risk factors. Furthermore, participants aged 46-64 years old, married
respondents, and Chinese participants, those with higher educational levels, and received
prior information demonstrated great awareness of eight modifiable risk factors for heart
attack. Multivariable logistic regression presented that participants with aged 55-64, those
with family history of heart attack and individuals with dyslipidemia were factors
independently related to excellent awareness. Finally, Awareness of risk factors for heart
attack appears to be poor, where most of the respondents recognized only one modifiable risk
factor.
Citation Ahmed AAA;Al-Shami AM;Jamshed S;Zawiah M;Elnaem MH;Mohamed Ibrahim MI; (n.d.).
Awareness of the risk factors for heart attack among the general public in Pahang, Malaysia:
A cross-sectional study. Risk management and healthcare policy. Retrieved February 3, 2023,
from https://pubmed.ncbi.nlm.nih.gov/33380849/
Purpose  To assess the awareness of risk factors for heart attack and to identify the factors associated with the
awareness of all modifiable risk factors for heart attack in the general population.
Sample 393 adult individuals in Kuantan, Pahang, Malaysia.
Design cross-sectional study
Measure Data collection was conducted through face-to-face interviews among the lay public members who
were 18-64 years old, excluding healthcare professionals in clinical settings and academic settings.
ment
Statistical analysis was performed using chi-square test and logistic regression analysis.
Result The majority of the individuals identified smoking as a risk factor for heart attack, followed by atrial
fibrillation (57.7%), heart disease (54.1%), and obesity (53.8%). However, diabetes (26%) was the
risk factor that was least recognized by the participants. A total of 90.6% of participants identified at
least one risk factor for heart attack, while 9.8% of the participants did not identify any risk factors
for heart attack, whereas 5.6% identified all modifiable heart attack risk factors. Furthermore,
participants aged 46-64 years old, married respondents, and Chinese participants, those with higher
educational levels, and received prior information demonstrated great awareness of eight modifiable
risk factors for heart attack. Multivariable logistic regression presented that participants with aged 55-
64, those with family history of heart attack and individuals with dyslipidemia were factors
independently related to excellent awareness.

Evidence no.6
To study the Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in
the Lebanese Population.

A cross sectional study was conducted by Marc Machaalani et al, 2022, to study the
Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in the Lebanese
Population. The study showed that cardiovascular diseases (CVD) are the leading cause of
death globally. Where to assessing CVD knowledge, attitude, and practice (KAP) is
necessary to spread awareness about CVD in Lebanon. The study included 921 CVD and
non-CVD subjects. A questionnaire form was used to collect data related to
patients' demographics, socioeconomic status, habits, medical and family history, KAP
towards CVD, and source of information. Data was analyzed using SPSS v.25. Where the
results showed CVD patients were significantly older than non-CVD subjects (p < 0.001). All
three KAP scores of both groups were of poor to fair levels. Both CVD knowledge and
attitude mean scores in CVD patients (26.6 ± 5.2 over 40 [66.50%] and 63.3 ± 10.2 over 85
[74.47%], respectively) were significantly higher than the ones of non-CVD subjects (23.5 ±
7.9 over 40 [58.75%] and 61.4 ± 12.4 over 85 [72.74%], respectively, p < 0.001). However,
the CVD mean practice score was significantly lower in CVD patients (6.0 ± 1.7 over 9
[66.67%]) than the one of non-CVD subjects (6.3 ± 2.2 over 9 [70.00%] p < 0.001). Mostly,
educational level (p < 0.001), governorate (p < 0.01), and smoking (p < 0.001) were
predictors of KAP CVD in both groups. As shown by the results the Lebanese
population (with CVD or non-CVD) needs targeted national campaigns about CVD
according to the identified predictors of CVD KAP to prevent and to alleviate the
complications due to CVDs.
Citation
Machaalani M, Fakhry B, Zwaideh M, Mendelek K, Mahmoud N, Hammoud T, Chahine MN.

Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in the Lebanese Population. Glob

Heart. 2022 Jul 29;17(1):47. doi: 10.5334/gh.1138. PMID: 36051313; PMCID: PMC9336688.
Purpose
Assessing CVD knowledge, attitude, and practice (KAP) is necessary to spread awareness about

CVD in Lebanon.
Sample
Targeted 921 CVD and non-CVD subjects

Design
 Case-control analytical study
Measure
questionnaire form was used to collect data related to patients' demographics, socioeconomic status,
ment
habits, medical and family history, KAP towards CVD, and source of information. Data was analyzed

using SPSS v.25.

Result
An overall limited knowledge, attitude, and practice toward CVDs, the Lebanese population (with

CVD or non-CVD) needs targeted national campaigns about CVD according to the identified

predictors of CVD KAP to prevent and to alleviate the complications due to CVDs.

Evidence no.7
Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among
Adults in the United States.

The study conducted in 2019 Dec 2 by Shiwani Mahajan 1, Javier Valero-Elizondo, Rohan
Khera , Nihar R Desai , Ron Blankstein , Michael J Blaha , Salim S Virani , Bita A Kash ,
William A Zoghbi , Harlan M Krumholz , Khurram Nasir . The aim of the study is to
understand the variation and disparities in awareness of myocardial infarction symptoms
among adults in the United States. The Main outcomes and measures of the study are
prevalence and characteristics of individuals who were unaware of myocardial infarction
symptoms and/or chose not to call emergency medical services in response to these
symptoms. The result isAmong 25 271 individuals (13 820 women [51.6%; 95% CI, 50.8%-
52.4%]; 17 910 non-Hispanic white individuals [69.9%; 95% CI, 68.2%-71.6%]; and 21 826
individuals [82.7%; 95% CI, 81.5%-83.8%] born in the United States), 23 383 (91.8%; 95%
CI, 91.0%-92.6%) considered chest pain or discomfort a symptom of myocardial infarction;
22 158 (87.0%; 95% CI, 86.1%-87.8%) considered shortness of breath a symptom; 22 064
(85.7%; 95% CI, 84.8%-86.5%) considered pain or discomfort in arm a symptom; 19 760
(77.0%; 95% CI, 76.1%-77.9%) considered feeling weak, lightheaded, or faint a symptom;
 and 16 567 (62.6%; 95% CI, 61.6%-63.7%) considered jaw, neck, or back pain a symptom.
Overall, 14 075 adults (53.0%; 95% CI, 51.9%-54.1%) were aware of all 5 symptoms,
whereas 4698 (20.3%; 95% CI, 19.4%-21.3%) were not aware of the 3 most common
symptoms and 1295 (5.8%; 95% CI, 5.2%-6.4%) were not aware of any symptoms. Not
being aware of any symptoms was associated with male sex (odds ratio [OR], 1.23; 95% CI,
1.05-1.44; P = .01), Hispanic ethnicity (OR, 1.89; 95% CI, 1.47-2.43; P < .001), not having
been born in the United States (OR, 1.85; 95% CI, 1.47-2.33; P < .001), and having a lower
education level (OR, 1.31; 95% CI, 1.09-1.58; P = .004). Among 294 non-Hispanic black or
Hispanic individuals who were not born in the United States, belonged to the low-income or
lowest-income subgroup, were uninsured, and had a lower education level, 61 (17.9%; 95%
CI, 13.3%-23.6%) were not aware of any symptoms. This group had 6-fold higher odds of
not being aware of any symptoms (OR, 6.34; 95% CI, 3.92-10.26; P < .001) compared with
individuals without these characteristics. Overall, 1130 individuals (4.5%; 95% CI, 4.0%-
5.0%) chose a different response than calling emergency medical services in response to a
myocardial infarction.

Citation Shiwani Mahajan, Javier Valero-Elizondo , Rohan Khera , Nihar R Desai , Ron Blankstein , Michael
J Blaha , Salim S Virani , Bita A Kash , William A Zoghbi , Harlan M Krumholz , Khurram Nasir
Purpose To understand the variation and disparities in awareness of myocardial infarction symptoms among
adults in the United States.
Sample 25 271 adults in the US.
Design Cross-sectional study used data from the 2017 National Health Interview Survey among adult
residents of the United States.
Measure Assessing awareness of the 5 following common myocardial infarction symptoms among different
ment sociodemographic subgroups: chest pain or discomfort, shortness of breath, pain or discomfort in
arms or shoulders, feeling weak, lightheaded, or faint, and jaw, neck, or back pain. The response to a
perceived myocardial infarction (ie, calling emergency medical services vs other) was also assessed.
Result Overall, 14 075 adults (53.0%; 95% CI, 51.9%-54.1%) were aware of all 5 symptoms, whereas 4698
(20.3%; 95% CI, 19.4%-21.3%) were not aware of the 3 most common symptoms and 1295 (5.8%;
95% CI, 5.2%-6.4%) were not aware of any symptoms. Not being aware of any symptoms was
associated with male sex (odds ratio [OR], 1.23; 95% CI, 1.05-1.44; P = .01), Hispanic ethnicity (OR,
1.89; 95% CI, 1.47-2.43; P < .001), not having been born in the United States (OR, 1.85; 95% CI,
1.47-2.33; P < .001), and having a lower education level (OR, 1.31; 95% CI, 1.09-1.58; P = .004).
Among 294 non-Hispanic black or Hispanic individuals who were not born in the United States,
belonged to the low-income or lowest-income subgroup, were uninsured, and had a lower education
level, 61 (17.9%; 95% CI, 13.3%-23.6%) were not aware of any symptoms. This group had 6-fold
higher odds of not being aware of any symptoms (OR, 6.34; 95% CI, 3.92-10.26; P < .001) compared
with individuals without these characteristics. Overall, 1130 individuals (4.5%; 95% CI, 4.0%-5.0%)
chose a different response than calling emergency medical services in response to a myocardial
infarction.
The first evidence talks about knowledge and poor understanding factors of stroke and heart
attack symptoms in South Korea . The study's findings suggest that the general South Korean
population's knowledge of CVD has to be improved. While the second evidence talks about
knowledge and attitude of general people towards symptoms of heart attack and the impact of
delay time in Riyadh, Saudi Arabia. They discovered that men were more likely than women
to have limited knowledge. This study indicates that people are not aware of the symptoms
and indicators of a heart attack. Coming to Brazil, as the third evidence where about
assessing knowledge cardiovascular disease and response to acute cardiac events in three
municipalities in it, as supporting the previous evidence which the findings indicate the need
for interventions to improve public knowledge and response to acute cardiovascular events in
Brazil as a first step towards improving health outcomes in this population. As well as the
fourth the study showed the overall knowledge and awareness of CAD was suboptimal,
indicating that awareness initiatives and patient education of CAD need more work in Saudi
Arabia, especially in high-risk groups and lower education groups. More studies are needed
to identify the efficiency and population access of different approaches for CAD awareness.
Fifth evidence was about to study the awareness of the Risk Factors for Heart Attack Among
the General Public in Pahang, Malaysia. The result shows that the majority of the individuals
identified smoking as a risk factor for heart attack, followed by atrial fibrillation, heart
disease, obesity and diabetes. Finally, Awareness of risk factors for heart attack appears to be
poor, where most of the respondents recognized only one modifiable risk factor. Last but not
least, in Lebanon we found research aims to study the Knowledge, Attitude, and Practice
Toward Cardiovascular Diseases in the Lebanese Population. As it highly supports our
studies the overall limited knowledge, attitude, and practice toward CVDs, the Lebanese
population (with CVD or non-CVD) needs targeted national campaigns about CVD
according to the identified predictors of CVD KAP to prevent and to alleviate the
complications due to CVDs. The last evidence is about Variation and Disparities in
Awareness of Myocardial Infarction Symptoms Among Adults in the United States. The
result of this study shows that Many adults in the United States remain unaware of the
symptoms of and appropriate response to a myocardial infarction. In this study, several
sociodemographic subgroups were associated with a higher risk of not being aware. They
may benefit the most from targeted public health initiatives.
 Project Plan (Methodology)

.Target group: Young people from age 18 to 45 years old

.Setting for Health Education: Health Centre

Method Objectives

By preparing a questionnaire in Arabic containing simple To Assess the level of

questions to measure the awareness of young people (18- awareness about heart
45 years old) living in Muscat Governorate about heart attack
attack and distributing the questionnaire link on social
.media, then we analyze the results

By doing a poster showing the signs and symptoms of a To Educate the community
heart attack and making a table to differentiate between about signs and symptoms
the symptoms of a heart attack for women and men of heart attack

Make a game in which we put several pictures, some of To minimize risk factors of a
which show the risk factors for a heart attack and others .heart attack
not, and bring some people from the audience and make
them choose the factors that they think are related to
heart attacks, then we explain that to them

We will do an interview with a nurse who has experience To prevent complications of

in heart attacks, in which we will explain the .a heart attack
complications of a heart attack in front of the audience
 References

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