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Delays in the treatment of acute myocardial infarction: an overview
1Center for Evaluation of Emergency Medical Services, Seattle-King County Department of Public Health, WA 98104.
Insights
Timely treatment for acute myocardial infarction (AMI) is crucial. Delays in patient care, from symptom onset to hospital treatment, significantly reduce the effectiveness of reperfusion therapies for AMI.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- Acute myocardial infarction (AMI) requires prompt treatment for optimal outcomes.
- Significant delays occur between symptom onset and hospital arrival, and between hospital arrival and treatment initiation.
- Many patients do not utilize emergency medical services (EMS) for suspected AMI.
Purpose of the Study:
- To analyze the components of pre-hospital and in-hospital delays in treating acute myocardial infarction.
- To identify factors contributing to these delays.
- To discuss strategies for reducing treatment delays and their impact on prognosis.
Main Methods:
- Review of existing literature on treatment delays for acute myocardial infarction.
- Analysis of patient delay, emergency medical service (EMS) delay, and hospital delay.
- Discussion of factors influencing each delay component.
Main Results:
- Median delay from symptom onset to hospital arrival is 2-4 hours.
- Average delay from hospital arrival to thrombolytic therapy is 84 minutes.
- Approximately 50% of patients with suspected AMI do not use EMS.
Conclusions:
- Treatment delays for acute myocardial infarction limit the benefits of reperfusion therapy.
- Addressing patient, EMS, and hospital delays is essential for improving patient outcomes.
- Understanding delay factors can inform interventions to expedite AMI care and improve prognosis.
Abstract:
Delays in treatment of acute myocardial infarction prevent a substantial portion of patients from receiving maximal benefit from reperfusion therapy. Median delay between onset of symptoms and arrival at the hospital is 2 to 4 hours. Average time between arrival at the hospital and initiation of thrombolytic therapy is 84 minutes. Approximately 50% of patients hospitalized for suspected acute myocardial infarction do not use the emergency medical service system. Delay before treatment can be divided into several components: patient delay, emergency medical service delay, and hospital delay. Factors contributing to delay in each component and possible approaches to decreasing these delays are discussed. The effects of treatment delay on prognosis and future care-seeking behavior of patients hospitalized with suspected acute myocardial infarction are also discussed.