By Victoria Vaughan

DESPITE knowing that chest pains are an early warning sign of a heart attack, about a fifth of Singaporeans would lie down in bed and rest rather than seek medical help, according to an independent survey.

Conducted earlier this month, the 22-question survey was e-mailed to more than 400 people over the age of 16 and was demographically representative of the population.

The results, revealed to The Straits Times yesterday, found that while 70 per cent of Singaporeans surveyed knew chest pains and breathlessness are warning signs of a heart attack, 21.8 per cent did not see the need to seek medical attention.

A further 13.6 per cent of respondents would call an ambulance, while 15.6 per cent would immediately go to a hospital's accident and emergency department.

Dr Tan Swee Yaw, consultant cardiologist at the National Heart Centre Singapore (NHCS), said the survey results were interesting and that any extra information on public perception is very beneficial in knowing how to reach such people.

He noted there may be a cause for concern that a large number thought the first reaction to chest pains was to lie down and rest instead of seeing a GP or calling an ambulance, but it could also be how the questions were worded.

Dr Tan advised anyone suffering from severe and persistent chest pains for 10 to 20 minutes, with associated shortness of breath, to call an ambulance or head to hospital immediately.

When it comes to why some with chest pains avoid a trip to the hospital, the top reason for men was a concern over financial matters such as potential loss of pay, recovery period and cost of treatment. For women it was fear of diagnosis, surgery and side effects.

But Associate Professor Koh Tian Hai, medical director of the NHCS, said: 'It's important to look after your health as in the long run it may end up costing you more. In Singapore, no patients are denied medical treatment due to cost alone.'

The survey also showed more than half of respondents think heart disease is not as deadly as cancer. However, cardiovascular disease, which includes stroke and heart disease, is the leading cause of death and claims 15 lives each day - just under a third of all deaths in 2008. Cancer was responsible for 29.3 per cent of deaths that same year.

More than three-quarters of respondents accurately picked the risk factors for heart disease including high cholesterol, high blood pressure and bad diet, but only 36 per cent knew diabetes was also a risk factor.

The former chairman of Singapore Heart Foundation, Dr Low Lip Ping, said more education was needed in this area.

'The finding does not surprise me as with diabetics we can sometimes focus too much on glucose levels but there are other related risk factors such as heart disease. Diabetics can also suffer from high blood pressure and cholesterol,' he said.

The survey to gauge local awareness of heart disease was commissioned by German health-care company B. Braun and carried out by market research agency BDM Intelligence in collaboration with international marketing agency Ogilvy and Mather.

» Next: Many lack awareness and knowledge

Matters of the heart

Cardiovascular disease was the top killer in Singapore in 2008, accounting for 32.4 per cent of all deaths. But an online survey of 404 Singaporeans (16 years and older) earlier this month by German health-care company B. Braun found that many lacked awareness and knowledge of the disease.

TOP FIVE REASONS FOR NEGLECTING CHEST PAINS*

Majority would neglect chest pains because of concerns over cost of treatment.

Worried about cost of treatment - 51.5%
Fearful of diagnosis - 32.2%
Afraid of surgery - 30.2%
Worried about recovery
period/loss of pay - 19.6%
Worried about side effects - 18.3%

REACTIONS TO CHEST PAINS

About one in five would lie down in bed if experiencing chest pains.

Lie down in bed and rest - 21.8%
Go to GP - 20%
Call family - 18.8%
Go to hospital/ER - 15.6%
Call an ambulance - 13.6%
Don't know/Not sure - 6.7%
Others - 3.5%

HEART ATTACK WARNING SIGNS*

Confusion between signs of heart attack and stroke
When asked to choose heart attack symptoms from a list of 10 warning signs (comprising five signs each of stroke and heart attack), 42.1 per cent selected stroke signs instead, which are mainly numbness of limbs and loss of balance/coordination.

Chest discomfort/pains - 96%
Shortness of breath - 90.1%
Cold sweat - 64.6%
Back or jaw discomfort/pains - 27.2%
Nausea/vomiting - 23.8%

NOTE: * Figures do not add up to 100% as respondents could pick more than one answer

This article was first published in The Straits Times.