Public awareness of symptoms of a heart attack dipped further, according to a study by the Centers for Disease Control and Prevention. Based on a poll in 13 states and the District of Columbia, the survey said the percent of Americans knowledgeable of heart attack symptoms is down to 25 percent from 33 percent in 2001.

Dr. Jing Fang, main author of the study, said the results of the survey is a cause for alarm in the American health community. The biggest number of those aware of heart attack signs were white, well educated women. West Virgina had a high rate of heart attack knowledge, as well as heart attack incidents.

Annually over 900,000 Americans experience a heart attack, of which 157,000 die. Fifty percent of that number pass away within an hour after they experienced the symptoms.

Heart attack symptoms include breath shortness, pain in the chest area and arms or shoulder, weakness and discomfort near the face, particularly the jaw, neck or back. Those who feel these symptoms should call right away 911 for assistance.

Other major contributory factors to heart attack deaths, aside from lack of knowledge, are financial reasons, explaining the hesitancy to proceed to a medical facility despite the pains experienced.