Appropriate strategies for South Africa for the management of acute myocardial infarction in patients presenting with ST-segment elevation

Abstract

Both patient and health-system delays contribute to delays in restoring myocardial perfusion. Patient-related delays constitute the time from onset of symptoms to the call for help, and onset of symptoms to first medical contact. These will not be discussed here. Of relevance are time metrics relating to ‘symptom onset to initiation of fibrinolysis or first balloon or device, and hospital door to either onset of fibrinolytic therapy (door-to-needle time) or to first balloon or device (door-to-balloon time)’, as well as strategies that may be considered if circumstances are not ideal, as elegantly interrogated by Gershlick et al.