title: [Early diagnosis of acute myocardial infarct].
abstract: Inappropriately long patient time delay (PTD) is the main cause for undesirable pre-hospitalization delay, so called global pre-hospital time delay (GTD). The fact that patients treated for cardiovascular diseases have long GTD is alarming. General awareness of basic symptomatology and of the importance of time factor for further course of the disease may substantially influence the duration of AIM pre-hospitalization phase. Pre-hospitalization care of patient is a very demanding task for the first-contact physician (most often general practitioner) mainly because of the symptomatology variability. If there is a suspicion for AIM it is recommended to treat the patient as life-threatened and to assure the transport to hospital as rapid and "comfortable" as possible. The organisational structure of emergency units in hospitals must accept the main presumption for future treatment success-vital importance of immediate management of possible AIM patient. In this connection most important task for the doctor is rapid diagnostics, because of the requirement for hospitalization at coronary unit or intensive care unit and the need for urgent treatment. Exceptional attention must be paid to AIM high risk patients. Unrecognition of AIM, mainly in the early period, when the diagnostic process may be difficult, can have catastrophic consequences: 1. sudden cardiac death due to ventricular fibrilation and 2. impossibility to administer fibrinolytic therapy in the period of its maximum treatment. At the present state of knowledge because of the consequences of undiagnosed AIM it is safer to presume cardiac origin of the symptoms, above all of pain until proving other reason. Therefore the idea of so called Chest Pain Evaluation Units seems to be very interesting.
authors.affiliation: Dpt of Internal Medicine, Slovak Postgraduate Academy of Medicine, Bratislava.
authors.forename: Z
authors.initials: Z
authors.lastname: Motovska
authors.forename: S
authors.initials: S
authors.lastname: Cagan
authors.forename: M
authors.initials: M
authors.lastname: Pavlovic
mesh_terms: D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D013997:Time Factors