Knowledge, attitudes, and beliefs about acute coronary syndrome in patients diagnosed with ACS: An Irish cross-sectional study

Background: To reduce mortality and morbidity associated with acute coronary syndrome (ACS), individuals who experience ACS symptoms should seek treatment promptly. However, for this to be possible, they must adopt appropriate attitudes and beliefs about ACS symptoms and have the prerequisite knowledge to respond to those symptoms. Aim: This paper details the results of a cross-sectional Irish study that measured knowledge, attitudes, and beliefs about ACS in patients diagnosed with ACS. Methods: A total of 1947 patients were enrolled in the study. Recruitment took place across five academic teaching hospitals in Dublin, Ireland. Knowledge, attitudes, and beliefs about ACS were measured using the ACS Response Index questionnaire. Results: Almost half the patients (n=49.5%) demonstrated high knowledge levels (i.e. >70% of correct answers) about ACS symptoms. The majority recognized chest pain/pressure (98.9%) and left arm pain (90.2%) as symptoms. Many failed to associate jaw pain, heartburn and/or indigestion (44.7%), nausea and vomiting (47.6%), and neck pain (42.5%) with a heart attack. Higher knowledge levels were independently associated with higher levels of education (p=0.007), a history of angina (p=0.001), and attitudes (p=<0.001) and beliefs (p=<0.001) that are consistent with positively decisive responses to ACS symptoms. Conclusion: Despite having experienced an ACS event, overall knowledge levels were poor. Higher knowledge levels were associated with better attitudes and beliefs, indicating the inextricable relationship between all three components. Educational programmes should incorporate all three components so that prompt behaviour can be initiated when symptoms arise.