The importance of early treatment of myocardial infarction and approaches for shortening delays in securing medical care.
The present study was conducted on 597 patients with acute myocardial infarction (AMI) who were treated at the coronary care unit (CCU) of Asahikawa Municipal Hospital from January, 1971 to December, 1982. Among 202 patients who were hospitalized within 2 hours after the onset of AMI, 27 (13.4%) developed primary ventricular fibrillation (PVf), 14 patients before hospitalization. Of these 27 patients, 25 (92.6%) were successfully resuscitated and 12 (44.4%) were discharged alive. On the other hand, of 43 patients who were seen within 15 min after the onset of AMI, 11 (25.6%) were diagnosed as having PVf. We divided a series of 365 AMI patients who were seen from 1971 to 1980 into two groups: one group consisted of 178 patients seen within 6 hours after the onset of symptoms, and the other group of 187 patients seen after 6 hours after the onset. The incidence of heart failure with Killip's class 2,3 and 4 was less in the former group than the latter (p less than 0.01). Delays in providing prompt medical treatment appear to be due to the physicians' delayed response, transportation facilities as well as the patients themselves. Public education should help considerably in reducing the time period between the occurrence of symptoms and better medical care.
D003325:Coronary Care Units; D004632:Emergency Medical Services; D006266:Health Education; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012151:Resuscitation; D013997:Time Factors; D014187:Transportation of Patients