Heart attack, also known as myocardial infarction (MI), is a life-threatening cardiovascular event characterized by the sudden blockage of blood flow to the heart muscle. It remains a leading cause of morbidity and mortality worldwide, posing a significant public health challeng. The identification of heart attack symptoms and recognition of associated risk factors are crucial for timely medical intervention, which can substantially improve patient outcomes and reduce the burden on healthcare systems [1,2].

In metropolitan cities like Mumbai, India, where the pace of life is often fast and lifestyle changes are prevalent, the incidence of heart attacks is on the rise. Early recognition of heart attack symptoms and an understanding of the factors that contribute to its occurrence are essential for raising awareness among the general public and promoting proactive measures for prevention [3-5]. Several studies have emphasized the knowledge gap among the general public regarding heart attack symptoms and risk factors, leading to delays in seeking medical help during a heart attack, which can be life-threatening. Understanding the level of knowledge among the general population about heart attack symptoms and risk factors is crucial for designing targeted educational campaigns to improve awareness and prompt appropriate action during cardiac emergencies [6,7].

The present study aims to conduct a descriptive cross-sectional investigation to assess the knowledge about heart attack symptoms and risk factors among the general public of Mumbai. By identifying gaps in knowledge, this study intends to provide valuable insights for healthcare policymakers and practitioners to design effective educational interventions and public health strategies aimed at reducing the incidence and impact of heart attacks in the city. Empowering the public with accurate information can potentially lead to early detection and timely medical attention, ultimately contributing to better cardiovascular health outcomes and a healthier community.

Objectives of the Study

To evaluate the awareness and knowledge regarding Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among general public of Mumbai. 

Research Approach

The research approach adopted for this study is descriptive, aiming to assess the knowledge about heart attack symptoms and risk factors among the general public of Mumbai.

Research Design

The study utilizes a cross-sectional survey design to collect data at a specific point in time, allowing for the assessment of the knowledge level among participants.

Study Area

The research was conducted in Mumbai, one of the largest metropolitan cities in India.

Study Duration

The study was conducted between March 2023 and May 2023.

Study Population

The study population includes all adults above 18 years of age who have been residing in Mumbai for a minimum of 12 months.

Sample Size

The sample size was determined to be 400 adults, assuming that 50% of the participants have adequate knowledge about heart attack symptoms and risk factors. A 5% absolute error, 95% confidence level, and 5% non-response rate were considered during sample size estimation.

Study Tool

A structured Google Form questionnaire was designed to gather information on socio-demographic characteristics and knowledge about heart attack symptoms and risk factors. The questionnaire underwent pre-testing on a small group of individuals to ensure clarity and understanding.

Description of Tool

Demographic Data Survey Instrument: This section collected background information such as age, gender, marital status, religion, employment, and education.

Questionnaire

This section comprised 20 structured questions related to knowledge about heart attack symptoms and risk factors. Each correct answer was awarded one mark, while incorrect answers received zero marks. The maximum possible score was 20, and the minimum was zero for each category. Knowledge levels were categorized as follows: > 80% (16-20) - very good, 60-79% (12-15) - good, 41-59% (8-11) - fair, and <40% (<8) - poor.

Validity of Tool

The questionnaire was validated by experts in the field to ensure its accuracy and appropriateness.

Data Collection

Data collection was conducted under the supervision of supervisors. The Google Form questionnaire was distributed via various online modes, including email and social media platforms such as WhatsApp groups, Facebook, Instagram, and LinkedIn. Data collection was carried out in both rural and urban areas of Mumbai until 400 responses were obtained.

Data Analysis

The collected data were entered into a Microsoft Excel spreadsheet and checked for errors. Epi Info V7 software was used for data analysis, and appropriate statistical tests, such as frequencies and percentages, were employed.

Ethical Considerations

The study strictly adhered to ethical guidelines. Participants' confidentiality and anonymity were maintained throughout the research process to ensure their privacy and protection of personal information.

The goal of the current study was to assess general public knowledge regarding Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) through a non-experimental descriptive survey (Table 1). 

Table 1: Socio-Demographic Characteristics of Study Participants

A total of 400 respondents took part in the study, with 268 (67%) coming from urban areas and 132 (33%) from rural areas. The majority's participants included 358 (89.5 percent) Hindus, 262 (65.5 percent) males, 171 (42.75 percent) people in their 18 to 30s, 151 (37.75 percent) graduates, 262 (65.5 percent) working people, and 237 (59.25 percent) married people (Table 2).

Table 2: Knowledge Regarding Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among Study Participants

In the present study 29.75% (119) participants had very good knowledge (16-20 marks) towards, Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) ,41.5% (166) had good knowledge (12-15 marks), 18.5% (74) had fair knowledge (8-11 marks) and 10.25% (41) having poor knowledge (<8 marks).

Figure 1: Knowledge Scores, Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among Study Participants

The present study aimed to assess the knowledge of the general public in Mumbai regarding heart attack symptoms and risk factors. The findings reveal a significant knowledge gap, highlighting the need for targeted educational interventions to improve awareness and promote preventive measures.

In our study, only 91.25% of respondents correctly identified a heart attack as myocardial infarction. This indicates that nearly 9% of the participants lacked a clear understanding of the term "heart attack." Similar observations were made in other studies conducted in various countries, where a considerable proportion of the population showed confusion or limited awareness regarding the terminology of a heart attack [7-11].

The awareness of common heart attack symptoms was relatively low, with only 75.75% of respondents being able to identify them correctly. Chest pain and shortness of breath, which are cardinal symptoms of a heart attack, were not recognized by nearly 25% of the participants. This finding is consistent with previous studies that have shown a lack of knowledge about heart attack symptoms among the general public [10-13].

Regarding risk factors, approximately 71.75% of the participants correctly identified them in our study. However, a significant proportion of the population still lacks awareness about the factors that increase the likelihood of a heart attack. This finding aligns with other research studies, which have also reported inadequate knowledge of heart attack risk factors among the general population [12-15]. Furthermore, our study highlights the importance of lifestyle factors in heart attack risk. While 60.75% of participants were aware of lifestyle factors that can increase the risk of a heart attack, a considerable proportion still lacked knowledge in this area. This underscores the need for public health campaigns and interventions to educate individuals about the impact of lifestyle choices on heart health.

Importantly, only 24.5% of respondents knew how to perform CPR in case of a heart attack emergency. This indicates a critical knowledge gap, as prompt CPR can significantly improve survival rates during a cardiac emergency. Similar studies have shown low levels of CPR knowledge among the general public, emphasizing the need for widespread CPR training programs [13-16].

Additionally, the study reveals limited awareness of the "Golden Hour" concept, which refers to the critical first hour after a heart attack when timely medical intervention can greatly influence patient outcomes. Only 25.75% of participants were aware of the importance of the "Golden Hour" in heart attack management. This lack of knowledge highlights the need for public education on the urgency of seeking medical help during a heart attack [12-16].

Although the study identified knowledge gaps, it also revealed some positive aspects. For instance, 69% of participants recognized the benefits of regular exercise in preventing heart attacks, and 71.75% understood the importance of health check-ups and risk assessment for heart disease. This indicates that there is some awareness among the public about preventive measures for heart health, but efforts are needed to reinforce and expand this knowledge.

Comparing our results with other studies, our findings are consistent with previous research that has shown inadequate knowledge of heart attack symptoms and risk factors among the general public worldwide [8-16]. This highlights the global nature of the issue and emphasizes the need for comprehensive educational campaigns on heart health.

Limitations

One limitation of this study is the reliance on self-reported data through an online questionnaire, which may introduce response bias. Participants might provide socially desirable responses or misinterpret certain questions, leading to potential inaccuracies in their knowledge assessment. Additionally, the study's cross-sectional design only allows for a snapshot of knowledge at a specific point in time, without considering any temporal changes or long-term trends in awareness. The sample population was limited to adults residing in Mumbai, which might not fully represent the diverse demographics and cultural backgrounds present in the entire region. Furthermore, despite efforts to ensure clarity in the questionnaire through pre-testing, some participants might still have faced difficulties in understanding certain items, which could impact the accuracy of their responses. Future studies could consider employing a more diverse sampling strategy and longitudinal design to address these limitations and provide a comprehensive assessment of knowledge about heart attack symptoms and risk factors among the general public.

The present study demonstrates a significant knowledge gap among the general public in Mumbai regarding heart attack symptoms and risk factors. Improving public awareness is essential for timely medical intervention and effective management of heart attacks. Public health campaigns should be designed to address these knowledge gaps and promote preventive measures, such as lifestyle modifications and CPR training. By empowering the public with accurate information, we can take significant strides towards reducing the burden of heart attacks and improving cardiovascular health outcomes in Mumbai.

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