Article Text

Download PDFPDF
Myocardial infarction symptom recognition by the lay public: the role of gender and ethnicity
  1. Pamela A Ratner1,
  2. Roula Tzianetas1,
  3. Andrew W Tu1,
  4. Joy L Johnson1,
  5. Martha Mackay3,
  6. Christopher E Buller3,
  7. Maureen Rowlands2,
  8. Birgit Reime2
  1. 1Nursing and Health Behaviour Research Unit, School of Nursing, University of British Columbia, Vancouver, Canada
  2. 2NEXUS, University of British Columbia
  3. 3St. Paul’s Hospital, Vancouver, Canada
  1. Correspondence to:
 Dr P A Ratner
 Nursing and Health Behaviour Research Unit, School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada; pam.ratner{at}


Study objective: To find out if gender and ethnicity are associated with acute myocardial infarction (AMI) symptom recognition and the recommendation of enlisting emergency medical services.

Design: In an experiment, a random sample of the public was provided a scenario of a person experiencing symptoms of AMI; the gender of the character (male, female, or indeterminate) was manipulated.

Setting: Vancouver, Canada

Participants: 976 people from a population based random sample of 3419 people, 40 years of age and older, participated in a telephone survey given in English, Cantonese, Mandarin, and Punjabi.

Main results: 78% of the respondents identified the symptoms as heart related. Unadjusted analyses showed that ethnicity, education, income, and AMI knowledge were significantly associated with symptom recognition (Chinese respondents were least likely to identify the symptoms as heart related). Thirty seven per cent recommended calling emergency services, which was associated with symptom recognition, ethnicity (Chinese respondents were least likely to make the recommendation), AMI knowledge, having an immediate family member with AMI, and having talked with a health professional about the signs and symptoms of AMI. Neither the gender of the respondent nor of the affected person in the scenario was associated with symptom recognition.

Conclusions: Heart health education must be targeted to and tailored for ethnic communities. Health professionals must discuss the signs and symptoms of AMI, and the correct course of action, with their patients.

  • myocardial infarction
  • time factors
  • early diagnosis
  • sex factors
  • ethnic groups

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • * Adapted from Chaturvedi et al.26

  • Funding: this research was supported by a grant from the Canadian Institutes of Health Research. PAR and JLJ were supported via personnel awards from the Canadian Institutes of Health Research. BR was supported by NEXUS with funding from the Michael Smith Foundation for Health Research.

  • Conflicts of interest: none.

  • Ethics approval: approval for accessing the list and conducting the study was received from the Ministry of Health’s Confidentiality Agreement: Security Provisions for Personal Information in Individual Identifiable Form and from the University of British Columbia’s Behavioural Research Ethics Board, respectively. The study conforms to the principles embodied in the Declaration of Helsinki and the Canadian Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans.

Linked Articles

  • In this issue
    Carlos Alvarez-Dardet John R Ashton