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Study objective: To find out if gender and ethnicity are associated with acute myocardial infarction (AMI) symptom recognition and the recommendation of enlisting emergency medical services. Design: In an experiment, a random sample of the public was provided a scenario of a person experiencing symptoms of AMI; the gender of the character (male, female, or indeterminate) was manipulated. Setting: Vancouver, Canada Participants: 976 people from a population based random sample of 3419 people, 40 years of age and older, participated in a telephone survey given in English, Cantonese, Mandarin, and Punjabi. Main results: 78% of the respondents identified the symptoms as heart related. Unadjusted analyses showed that ethnicity, education, income, and AMI knowledge were significantly associated with symptom recognition (Chinese respondents were least likely to identify the symptoms as heart related). Thirty seven per cent recommended calling emergency services, which was associated with symptom recognition, ethnicity (Chinese respondents were least likely to make the recommendation), AMI knowledge, having an immediate family member with AMI, and having talked with a health professional about the signs and symptoms of AMI. Neither the gender of the respondent nor of the affected person in the scenario was associated with symptom recognition. Conclusions: Heart health education must be targeted to and tailored for ethnic communities. Health professionals must discuss the signs and symptoms of AMI, and the correct course of action, with their patients. [ABSTRACT FROM AUTHOR]