Delay in Presentation in Patients with Acute Myocardial Infarction.

Abstract

Many patients of acute myocardial infarction (AMI) delay in seeking medical care, therefore miss the benefits of thrombolytic therapy. The cause of delay in presentation is influenced by age, sex, socio-economic factors, severity of symptoms, site of infarction and presence of complications. Both late presentation and treatment delay result in increased mortality. This study was designed to know the impact of different patient related parameters causing an significant delay in presentation to hospital. One hundred consecutive patients (79 males, 21 females) with AMI, presenting to Emergency Department were included and a questionnaire was filled in to evaluate the cause of delay in presentation. The mean hospital presentation time was 7 hours and 20 minutes. Younger patients reached earlier, male patients took less time, uneducated patients took more time. Public awareness in Lahore is 72%. Fifteen percent patients came late as they consulted their general practitioner. Location of infarct and Killip class III and IV at presentation were significantly associated with early presentation. This delay can be reduced by education and introduction of mobile coronary care units available on emergency phone call.