updated 7/31/2007 9:53:11 AM ET 2007-07-31T13:53:11

When people have heart attacks in the movies, they clutch their arms to their chests and double over in pain, crying out for help.

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In reality, the signs of a heart attack are much more subtle. Since symptoms can include mild pressure in the chest, lightheadedness and sweating, it's often hard for the average person to identify one.

That's what researchers at the Yale School of Medicine found in a study of 24 women 55 and under who'd had heart attacks and were admitted to a hospital. It showed that 42 percent didn't recognize the warning signs.

Despite the fact that 88 percent of the women had a family history of heart disease, many thought they had indigestion or heartburn, and half waited more than an hour to go to the emergency room, says Judith Lichtman, associate professor in epidemiology at Yale and lead author of the study.

Why the laid-back approach to their health? Recognizing the symptoms of a serious medical problem can be difficult for a lot of reasons, says Dr. Paul Auerbach, chair of the medical advisory board for Internet health information provider and clinical professor of surgery in the Division of Emergency Medicine at Stanford University Medical Center.

Detective work
First, few illnesses present themselves in a classic textbook fashion. People also frequently minimize their symptoms, possibly because they fear the worst. Symptoms like throat pain can be a sign of anything from strep throat to a heart attack. Making a correct diagnosis takes detective work for doctors, let alone the rest of us.

"[This is] arguably the most important topic anyone will have in life," Auerbach says, "and education about it stops in high school unless you pursue a health-care career."

Research has shown that your personality can affect how you react to medical symptoms too.

A 2005 study by the Washington University School of Medicine in St. Louis found that men with low overall anxiety levels were more likely to ignore symptoms of rectal cancer and delay treatment. Those with at least moderate anxiety levels, on the other hand, tended to quickly recognize symptoms such as rectal bleeding as a sign of a serious illness.

Dr. Michele Hanson, a consultant at the Mayo Clinic in Rochester, Minn., specializing in family medicine, says that while there's no exact formula for interpreting a symptom, the persistence of a health issue — like sustained weight loss without any effort, for more than a couple of weeks — should be a red flag. It could be a sign of stomach cancer and warrants a visit to the doctor's office.

Severe symptoms
If you find yourself describing a symptom, such as a headache, as the worst you've ever had in your life, or as sudden or extreme, you should also consider seeing a doctor. A new or unusually severe headache, especially for those over 50, could indicate anything from an aneurysm to a stroke.

Treating a stroke immediately, such as with a clot-busting tissue plasminogen activator, is crucial because it could have a major impact on the victim's recovery, says Dr. J. David Spence, author of How To Prevent Your Stroke and a professor of neurology and clinical pharmacology at the University of Western Ontario in London. Other possible symptoms include weakness or numbness of the face, arm or leg on one side of the body, thick or drunken speech and a loss of balance.

It's more important, of course, for people to know the signs of a stroke as they get older, since the likelihood of a stroke increases with age. It's up to each of us to know our disease risk factors, such as hypertension, diabetes, high cholesterol, a high body mass index, a family history of disease or a smoking habit.

Auerbach recommends, every few years or so, examining your health and the risk factors your age group might present, as well as disease symptoms.

And, no matter what, never let embarrassment or fear that you're wasting the doctor's time stop you from getting a symptom checked out.

"I never, nor should any doctor ever, resent seeing a patient who is genuinely concerned because they're having symptoms," Auberbach says. "That's our job."

© 2012


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