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Delay in presentation after myocardial infarction

A G Heriot1, S J Brecker, D J Coltart

  • 1Department of Cardiology, St Thomas Hospital, London, UK.

Journal of the Royal Society of Medicine
|November 1, 1993
PubMed
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Delays in seeking treatment for acute myocardial infarction (AMI) are common in the UK. Patients contacting their general practitioner (GP) experienced significantly longer delays, potentially reducing the effectiveness of thrombolytic therapy.

Area of Science:

  • Cardiology
  • Public Health

Background:

  • Thrombolytic therapy significantly reduces mortality in acute myocardial infarction (AMI) when administered early.
  • Delayed patient presentation in the UK may diminish the benefits of timely thrombolysis for AMI.

Purpose of the Study:

  • To assess the duration and causes of patient delay in seeking hospital care after the onset of chest pain in acute myocardial infarction (AMI).
  • To evaluate the impact of seeking general practitioner (GP) care versus direct hospital admission on overall treatment delay.

Main Methods:

  • A prospective interview-based study was conducted with 103 patients presenting with AMI at two London hospitals.
  • Data collected included time from chest pain onset to hospital arrival, reasons for delay, and patient awareness of thrombolytic treatments.

Related Experiment Videos

Main Results:

  • Nearly half (49%) of AMI patients experienced delays exceeding 2 hours, with 21% exceeding 4 hours.
  • Patients contacting their GP had significantly longer total delays (median 160 mins) compared to those using ambulances (82 mins) or self-transport (90 mins).
  • While decision time was similar, the travel time to hospital after deciding to seek care was substantially longer for patients consulting their GP (110 mins vs. 56 mins).

Conclusions:

  • Significant delays in patient presentation for AMI are prevalent in the UK, particularly when general practitioners are involved in the care pathway.
  • These delays may compromise the efficacy of time-sensitive thrombolytic therapy for acute myocardial infarction.
  • Increased public awareness of AMI symptoms and thrombolysis benefits, alongside streamlined emergency pathways, could improve treatment outcomes.