A hospital based study of patient and physician response to acute myocardial ischaemia - abstract

ABSTRACT

A prospective study was undertaken to investigate whether current patient and physician response to acute myocardial ischaemia was suffiently expedient to allow for thrombolysis within the first 6 hours of evolving acute myocardial infarction. During the 1-month study period, 70 patients with chest pain syndrome presented to the Accident and Emergency Department, General Hospital, Port-of-Spain (A&E, POSGH). Data were available on 67 patients, of whom 38 (57 percent) were found to have definite myocardial ischaemia by E.C.G. criteria. The modal time of arrival was 1-3 hours after the onset of chest pain. Sixty-four per cent of all patients arrived within 6 hours of the onset of chest pain. The corresponding figure for the subgroup with confirmed ischaemia was 68 percent. The mean time for evaluation and disposition of patients with confirmed ischaemia in the A&E, POSGH was 47.5 minutes (range 20-112 minutes). Furthermore, the longer time taken for triage of patients who did not have an eventual diagnosis of myocardial ischaemia (57.6 vs 47.5 min) is consistent with the urgency of physician management and the likelihood of ischaemia. The result of this study suggest that the majority of patients presenting to the A&E, POSGH for the treatment of acute myocardial ischaemic s