Many people with heart disease do not know the symptoms of a heart attack, even though their risk of suffering one is five to seven times higher than those with no such history, researchers reported yesterday.

Symptoms can include nausea and pain in the jaw, chest or left arm.

But the research team said shorter hospital stays and a move to outpatient treatment have decreased the amount of patient education on the subject.

Kathleen Dracup and colleagues at the University of California, San Francisco, School of Nursing said they looked at 3,522 patients in the United States, Australia and New Zealand who had previously suffered a heart attack or had undergone a procedure, such as angioplasty, for heart disease.

The researchers found that 44 per cent of the patients scored poorly on a true-false test measuring how savvy they were about the symptoms.

Women in general along with patients who had taken part in cardiac rehabilitation, those with higher education, younger people and those who were treated by a heart specialist rather than a family doctor tended to have the best scores on the test, said the report.

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