[A survey on the management of myocardial infarction in France.The Infarctus Top Chrono Survey].

An enquiry was carried out between December 1989 and January 1990 involving 749 cardiologists and 8,846 general practioners based throughout France to evaluate the number of myocardial infarctions diagnosed each year, to determine how the patients are transported to hospital and to assess the average delays of transportation. This enquiry showed that cardiologists diagnosed 15 cases of myocardial infarction per year: their first reflex is to visit the patient, sometimes accompanied by the emergency medical service if available at the time of the patient's call, or to advise the patient to call the emergency service straight away if it is not possible for them to visit the patient immediately. The delay of transportation is less than 30 minutes in 45% of cases and over 60 minutes in 10% of cases. Regional differences were observed and are analysed. General practitioners diagnose 4 cases of myocardial infarction per year: the principal attitude is the same as that of the cardiologists, except that the general practitioner is available to visit the patient more often and is called out more easily. The means of transport and the delays of transportation are very similar to those observed with the cardiologists. This analysis of the management of myocardial infarction in France in 1990 may help organise actions to shorten the time between the onset of chest pain and the institution of thrombolytic therapy.