ABSTRACT

Objective: To determine the door to thrombolysis time of patients who presented to the Adult Priority Care Facility of the Eric Williams Medical Sciences Complex from February 1 – May 31, 2008.

Method: The patients who presented to the Adult Priority Care Facility of the Eric Williams Medical Sciences Complex with cardiac type chest pain and ST segment elevation that met the international criteria and had positive troponin test were interviewed and their notes reviewed to obtain the relevant information.

Results: Fifty-one patients were treated with ST segment elevation myocardial infarctions; 78.4% were thrombolysed. Patients were: 59.75 years old, 68.6% male and 66.7% were of East Indian extraction. The average time to thrombolysis was 5 hours and 31 minutes from the onset of chest pain. The average door to thrombolysis time was 2 hours and 7 minutes with 20% of patients having a door to thrombolysis time of 30 minutes. The time to thrombolysis from the onset of chest pain and the door to thrombolysis times were adversely affected by the health facility to which the patient first presented.

Conclusion: The majority of patients presented within the thrombolysis window. Early recognition of symptoms of myocardial infarction and arrival at a healthcare facility is not being achieved by the majority of patients. The systems that are responsible for the transport, triage and treatment of patients who present with chest pain are inadequate and require urgent review and overhaul to achieve the goals outlined by the American Heart Association and the American College of Cardiologist.