Brits Killed by Stiff Upper Lip

Nov. 20, 2006 — -- The proverbial British stiff upper lip is killing thousands by keeping them from seeking immediate medical help when they suffer heart attack symptoms, according to a new survey from the British Heart Foundation. Americans may suffer the same fate, though for different reasons.

Rather than dial 999 -- the United Kingdom equivalent of the American 911 -- 64 percent of Britons who experience chest pains would rather stoically ignore those pains or talk to a friend or doctor, the heart foundation survey reports. They would not choose to seek urgent medical care.

But for a patient having a heart attack, every minute counts. The quicker a patient receives treatment, the greater the chances of survival.

The survey suggests that 40 percent of people would wait to see whether their chest pains went away before dialing an ambulance.

Four out of five people said they would doubt the seriousness of the symptoms.

'Hollywood' Heart Attack Not Typical

The first symptoms of a heart attack aren't as intense as most people expect them to be. The first symptoms often feel like indigestion and are ignored. They don't always resemble what doctors call the Hollywood heart attack, for example, in which a man dramatically clutches his chest and falls to the floor.

It's more subtle than that -- but just as deadly. Now the British Heart Foundation has launched a campaign called Doubt Kills to emphasize the deadliness of even subtle symptoms.

"These statistics portray a very worrying, and perhaps very British, reluctance to call 999 even in the most serious of emergencies," British Heart Foundation Medical Director Peter Weissberg said in a Doubt Kills campaign press release.

But this isn't a strictly British problem. Studies have shown that Americans are unlikely to go to emergency rooms during major sporting events, for example.

"We have similar problems in this country," said Dr. Raymond Gibbons, president of the American Heart Association and cardiologist at the Mayo Clinic in Rochester, Minn.

"Patients with heart attacks arrive at the hospital an average of about two hours after the onset of symptoms."

But some doctors believe Americans should know by now the importance of dialing 911 at the first sign of a heart attack. American doctors know and have long emphasized the importance of immediate treatment for heart attack patients.

Campaign Hopes to Speed Treatment

Last week, two major American heart organizations announced a new ambitious initiative designed to shave precious minutes off the time it takes to get a heart attack patient treated once that patient has entered the hospital.

That campaign is called the door-to-balloon, or D2B, alliance. Doctors estimate that the D2B alliance campaign could save thousands of lives each year.

Of course, the campaign only works if a patient actually shows up at the hospital.

"We could save more lives, and further reduce the size of heart attacks, if patients with symptoms called 9-1-1 sooner," said Gibbons.

So why are patients reluctant to act on a major medical emergency?

Reluctant Patients Act Against Common Sense

"Maybe it is [the British] natural reserve and stoicism, but it is costing lives," said Weissberg.

There's more than a stiff upper lip behind the phenomenon, doctors suggested. A big part of the explanation is old-fashioned denial.

"Sometimes people just don't want to believe they may be having a heart attack and therefore convince themselves that it is just indigestion or gas," said Dr. Deepak Bhatt, associate director of the Cleveland Clinic Cardiovascular Coordinating Center in Cleveland.

Pride plays a part, too.

"Sometimes, it is embarrassment," Bhatt said. "They know it is serious but do not want to draw attention to themselves, say, in a public gathering or an important business meeting,"

Some patients don't call because they worry they cannot afford the cost of medical care, or the cost of a false alarm.

But the cost of not calling could be deadly.

For more information on Heart Attacks and warning signs to watch for, check out the American Heart Association fact page.