Key findings:

A study in District Kangra, Himachal Pradesh, found high awareness of MI symptoms and risk factors among 400 adults, particularly regarding lifestyle factors. However, gaps exist in understanding the "Golden Hour," CPR, and stress management. Targeted education on these areas could improve preparedness for heart emergencies and enhance heart health outcomes.

What is known and what is new?

The study highlights existing awareness among District Kangra residents regarding MI symptoms and risk factors, with a focus on lifestyle-related factors. However, it also identifies novel areas of limited understanding, including the "Golden Hour," CPR, and stress management. Addressing these gaps through targeted education could improve emergency preparedness and enhance heart health outcomes in the region.

What is the implication, and what should change now?

The study's implications suggest a need for targeted educational interventions to address knowledge gaps, particularly regarding the "Golden Hour," CPR, and stress management. These interventions could improve the community's preparedness for heart emergencies and contribute to better heart health outcomes in District Kangra.

Heart attack, clinically known as Myocardial Infarction (MI), is a critical and often life-threatening cardiovascular event that poses a significant global health challenge. It results from the sudden interruption of blood supply to a part of the heart muscle, causing damage or cell death. Myocardial infarctions can have severe consequences on an individual's health and overall quality of life, making them a major concern in the realm of public health. [1-3]

In India, cardiovascular diseases (CVDs), including heart attacks, are a leading cause of morbidity and mortality, contributing significantly to the country's health burden. While urban areas and metropolitan regions have witnessed a surge in heart-related conditions due to lifestyle changes, rural areas, such as District Kangra in Himachal Pradesh, are not immune to the rising prevalence of these diseases. [4-6]

District Kangra, located in the picturesque state of Himachal Pradesh, presents a unique demographic and geographical landscape. Despite its scenic beauty, this district faces healthcare challenges, including the increasing burden of CVDs like myocardial infarction. Understanding the level of awareness and knowledge concerning the symptoms and risk factors associated with heart attacks among the general public in District Kangra is imperative for devising effective public health interventions and reducing the incidence and impact of this deadly condition.

A heart attack occurs when the blood supply to the heart muscle is obstructed, usually by a blood clot within a coronary artery. This interruption in blood flow results in the death of heart muscle cells. The primary risk factors for myocardial infarction encompass a range of lifestyle-related factors, including smoking, unhealthy diet, physical inactivity, obesity, high blood pressure, diabetes, and family history of heart disease. [7-9]

Public awareness and knowledge regarding the symptoms and risk factors of myocardial infarction play a pivotal role in early recognition and timely intervention. Studies have shown that a lack of awareness can lead to delays in seeking medical help, thereby adversely affecting treatment outcome. Moreover, an informed public is better equipped to adopt preventive measures, such as a heart-healthy lifestyle and regular health check-ups, to mitigate the risk of a heart attack. [10-12]

This study aims to address the knowledge gap regarding myocardial infarction symptoms and risk factors among the general public of District Kangra, Himachal Pradesh. By evaluating the existing awareness levels and identifying misconceptions, this research endeavors to contribute to the development of targeted public health campaigns and educational programs. Ultimately, the goal is to enhance awareness and understanding of myocardial infarction in District Kangra and empower its residents to make informed choices for heart health.

This study is timely and critical, given the growing prevalence of heart-related conditions in India and the potential for early intervention and lifestyle modifications to reduce the incidence of myocardial infarction. By shedding light on the awareness and knowledge gaps specific to District Kangra, we aim to facilitate the implementation of effective strategies for myocardial infarction prevention and management in this unique and diverse 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  District Kangra, Himachal Pradesh

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 District Kangra, Himachal Pradesh.

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 District Kangra, Himachal Pradesh 

Study Duration: The study was conducted between May 2023 and July 2023.

Study Population: The study population includes all adults above 18 years of age who have been residing in District Kangra, Himachal Pradesh 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: The questionnaire consisted of two sections:

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

2. 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 District Kangra Himachal Pradesh 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 the knowledge regarding Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among general public of District Kangra. A total of 400 respondents took part in the study, with 143 (35.75%) coming from urban areas and 257 (64.25%) from rural areas. Table-1

Table-1: Knowledge regarding Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among study participants

In the present study 26.75% (107)  participants had very good knowledge (16-20 marks) towards, Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) , 32.75% (129) had good knowledge (12-15 marks), 24% (96) had fair knowledge  (8-11 marks) and 17% (68) having poor knowledge  (<8 marks). Table-2

Table-2: Knowledge scores towards Symptoms and Risk Factors for Heart Attack (Myocardial Infarction) among study participants

The findings of this study offer valuable insights into the level of awareness and knowledge regarding the symptoms and risk factors for heart attacks (Myocardial Infarction, MI) among the general public of District Kangra, Himachal Pradesh. In India, cardiovascular diseases (CVDs), including heart attacks, continue to be a significant public health concern, contributing to a substantial burden of morbidity and mortality.

The study revealed a substantial level of awareness among the participants regarding several critical aspects of heart attacks. A significant majority of respondents correctly identified a heart attack (Myocardial Infarction) as a condition resulting from the interruption of blood supply to the heart muscle. They were also well-informed about common symptoms, risk factors, and lifestyle-related factors that can increase the likelihood of a heart attack. These high levels of awareness are encouraging and suggest that a significant portion of the population in District Kangra has a fundamental understanding of MI and its associated factors.

Participants in this study demonstrated commendable knowledge of risk factors associated with heart attacks. Factors such as smoking, physical inactivity, high blood pressure, diabetes, and obesity were correctly identified by a substantial proportion of respondents. This aligns with existing literature emphasizing the importance of these risk factors in the development of heart disease.

Despite the overall positive findings, there are specific knowledge gaps that warrant attention. A considerable number of participants were unaware of the "Golden Hour" concept in heart attack management, which underscores the critical importance of seeking medical help promptly. Additionally, knowledge about performing Cardiopulmonary Resuscitation (CPR) during a heart attack emergency was limited among the respondents. These findings highlight areas where educational efforts can be targeted to improve public preparedness for heart-related emergencies.

Comparing the findings of this study with similar research conducted in different regions of India, it becomes evident that the awareness levels regarding heart attack symptoms and risk factors are relatively consistent. [12-15] This suggests that the dissemination of knowledge about heart health and risk factors is not limited to specific regions but is a broader trend across the country.

Implications for Public Health

The results of this study have implications for public health interventions in District Kangra. While the awareness levels are promising, targeted educational programs could focus on the "Golden Hour" concept, CPR training, and stress management techniques to fill the identified knowledge gaps. Additionally, promoting regular health check-ups and screenings for heart disease risk assessment should be emphasized to encourage preventive healthcare measures.

Limitations

This study relied on self-reported data, which may be subject to recall bias and social desirability bias. The sample, though scientifically determined, may not fully represent the entire population of District Kangra. Future research could explore the impact of specific interventions on improving knowledge levels and assess their effectiveness in promoting heart health in the region.

In conclusion, this study highlights the encouraging levels of awareness and knowledge regarding symptoms and risk factors for heart attacks (Myocardial Infarction) among the general public of District Kangra, Himachal Pradesh. The findings suggest that a significant portion of the population possesses fundamental knowledge of MI and its associated factors. To further enhance preparedness for heart-related emergencies, targeted educational efforts can focus on areas of improvement, such as understanding the "Golden Hour," CPR training, and stress management techniques. These efforts can contribute to better heart health outcomes and a reduced burden of heart disease in this unique and diverse community.

Funding: No funding sources 

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of Bhoranj, H.P