[Delays in admissions for observation in suspected acute myocardial infarction]

One hundred and fifty-three patients hospitalized for observation and treatment of suspected acute myocardial infarction (AMI) were studied. The time delay from debut of symptoms until the decision was taken as to whether the patient was a candidate for treatment with thrombolysis or not was registered. The decision was made within four hours for 55.5% of the patients, and for 81.0% the decision was made within 12 hours of debut of symptoms. In all, 47 (30.1%) of the patients were treated with thrombolysis. Fifty-six (36.6%) of the patients had an AMI or unstable angina pectoris, and 39 (69.6%) were treated with thrombolysis. Seventeen patients with AMI did not receive the treatment, and for one of these the only reason for not receiving thrombolysis was a time delay longer than 12 hours. The median time for patient delay was 60 minutes, doctors' delay 39 minutes, and transport delay 29 min. At the hospital the first ECG was done 14 minutes after arrival, and the decision about whether to treat with thrombolysis or not was taken 25 minutes after arrival. It is still possible to diminish the time delays for patients suspected of AMI. The longest delay is due to the patient, and public education is needed to minimize patient delay. Doctors are recommended to refer patients suspected of AMI directly to the hospital, omitting a delaying visit to the patient.