INTRODUCTION

According to the  World Health Organization, coronary heart disease kills more people each year in high, middle and low income countries alike than any other disease. The 2012 Pan American report for Trinidad and Tobago showed a 51% raised risk for non-communicable lifestyle disease and the concomitant risk of cardiac disease in the 25–64-year age group with a reported increased rate of obesity, hypertension and diabetes (1).

The urgent management of the patient with acute coronary syndrome is dictated by the need to prevent irreversible damage and infarcted myocardium (2). The question of the advancement of technology and the availability of healthcare as it relate to service that is needed, cost of the service and the overall economic benefit, is forever being asked. Even though they are considered developing countries, Trinidad and Tobago and the wider Caribbean have kept up with the advancement of technology in early diagnosis and treatment of heart related problems. However, in Trinidad and Tobago where cardiovascular disease is reaching epidemic proportion, more work is required to educate the general public as well as providing a 24-hour integrated cardiac service. This will be possible only with a clear and committed service delivered as a joint effort between the private and public sectors (3).