Pain is not the only feature of heart attack

BMJ 1998;317:602 ( 29 August )

Letters

Pain is not the only feature of heart attack

The first 150 words of the full text of this article appear below.

EDITOR $---$ Ruston et al conclude that if we are to minimise the time between the onset of myocardial ischaemia and the administrationof thrombolysis "the myth that a heart attack is a dramatic eventneeds to be dispelled."¹ Perhaps medical advice that includesthe word "pain" is the single biggest problem. The article isbased on descriptions from patients, yet the word pain is usedonly once, and then in the final paragraph, when the authors citeadvice from health professionals. Pain is evidently the word usedby doctors and nurses, not untutored patients without prior experienceofischaemia.

When we stand on something sharp or touch something hot we have enough shared experience to identify and localise the experienceand communicate it to others. But nature has not equipped us withsufficient consistency of sensation to ascribe correctly any distressingsensations originating in the heart, aorta, oesophagus, gall . . . [Full text of this article]

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