Do you know the signs of a heart attack? According to a new study published in JAMA Network Open, nearly half of American adults may not realize they’re having a heart attack because they are unfamiliar with its symptoms, reports Reuters

Delaying going to the emergency room at the first indications of a heart attack increases people’s risk of heart damage, heart failure and sudden cardiac arrest. 

For the study, researchers reviewed the data of 25,271 U.S. residents age 18 or older who responded to the 2017 National Health Interview Survey, one of the nation’s largest in-person household health surveys. 

Participants were asked which of the following symptoms they believed were signs that someone is having a heart attack: chest pain or discomfort; shortness of breath; pain or discomfort in the arms or shoulders; feeling weak, lightheaded or faint; and jaw, neck or back pain.

More than half of participants (53%) correctly identified all five choices as heart attack symptoms; 20% didn’t know about the three most common symptoms; and 5.8% didn’t know any of the symptoms. 

People born outside the country and those of Hispanic ethnicity were almost twice as likely than others not to know the symptoms of a heart attack. In addition, participants with a lower level of education were 1.3 times more likely not to recognize any heart attack symptoms compared with individuals of a higher educational level. 

Among low-income Black and Hispanic immigrants with less education and no insurance, nearly one in five weren’t knowledgeable about any heart attack symptoms. In addition, people in this group were six times more likely to be unaware of symptoms compared with those who didn’t fall into this category. 

“The findings in the study are not surprising but underscore the need for more targeted education for those people with language barriers, cultural differences and less access to good health care,” said Icilma Fergus, MD, director of cardiovascular disparities at Mount Sinai Hospital in New York City, who wasn’t involved in the investigation. “These are the very groups who suffer from cardiovascular disparities.” 

For similar coverage, read “Can Hip-Hop Help Minority Children Recognize Signs of Stroke?” and “Hospitalizations for Heart Attacks Up Among Younger Women.”