[Can the delay in hospitalization be shortened in acute myocardial infarct?].

A reduction of the infarct-related mortality needs measures to diminish the extension of the infarction. A valuable approach is the thrombolysis, which proved useful in the past years. The aim of this study was to investigate the doctor's and the patient's behaviour related to the delay in hospital admission. During one year, the admission of 148 patients with suspected myocardial infarction was prospectively analysed. The median delay was 7.5 hours. 48% of the patients suffered from an acute myocardial infarction, 17% from an unstable angina, and 35% had no underlying heart disease. 38% reached the hospital within 4 hours (39% of the patients with confirmed myocardial infarction). The total delay was mainly due to the patients behaviour (median delay 3 hours) and in a lesser extent to the doctor's behaviour (median delay 1.5 hours). An immediate admission was only in 14% the first medical measure. In 40% an ECG was performed, in 6% a chest X-Ray, and in 11% laboratory investigations were undertaken. These results confirm the fact that people, especially the patients with known coronary artery disease should be better informed about the nature and the course of the illness and the efficient behaviour in case of onset of complications. The doctor's delay can be shortened by omission of useless diagnostic investigations.