A new report found that most U.S. adults are not aware of the warning signs and symptoms of a heart attack, and that the differences in awareness are based on race, geographical region, and sex.

The Centers for Disease Control and Prevention found that only 27 percent of adults would recognize all heart attack warning signs and would call emergency services if they suspected someone were having a heart attack or stroke, Jing Fang, M.D., and colleagues at the CDC wrote in the report.

The report was based on a 2005 telephone poll of 72,000 U.S. adults in 13 states and Washington, D.C. It also found that 14.3 percent of Hispanics know the signs of heart attack and the appropriate actions to take, compared to 16.2 percent of African –American people.

The residents of West Virginia were the best informed (35.5 percent), followed by residents of Iowa and Minnesota. The District of Columbia had the lowest proportion (16 percent). Heart disease is the leading cause of death in West Virginia, killing more than 6,000 people a year.

“There are few people in our state who don’t have some connection to someone who's had a heart attack. It makes them more aware, and they tend to pay more attention to those things. They know what to look out for,” Kevin Pauley, representative with the West Virginia chapter of the American Heart Association said.

Most participants knew at least a few heart attack symptoms, especially chest pain (92 percent) and shortness of breath (93 percent). Then there were pain or discomfort in the arms or shoulder (85 percent), feeling weak, lightheaded, or faint (62 percent) and pain or discomfort in the jaw, neck, or back (48 percent).

Dr. Fang warned that knowledge gap could be deadly. Certain drugs can stop heart attacks, but they should ideally be given within an hour after heart attack symptoms start.

Because the study included only people from 13 states and Washington, D.C., the findings may not represent all U.S. adults, Dr. Fang said.

More than 900,000 Americans suffer a heart attack each year, and about 157,000 of them are fatal.

The report was published online February 22, 2008 in Morbidity and Mortality Weekly Report.