Acute myocardial infarction in Doncaster. II. Delays in admission and survival

The speed of admission of patients with suspected acute myocardial infarction was observed over a period of 12 months during which a "no refusal" coronary care scheme was functioning, with emphasis on minimizing delay. During the same period the duration of survival of cases diagnosed as coronary thrombosis by the coroner's pathologist was measured. Comparison of the two series shows that 75% to 80% of the coroner's cases had died before the median time of notification of the general practitioner by those patients referred to hospital.We argue that the provision of mobile coronary care on request from general practitioners is unlikely to have an appreciable effect in preventing deaths from acute myocardial infarction outside hospital.