Abstract

*Dr. Faisal Anwar, Dr. Amna Abdul Karim and Dr. Sana Naseer

ABSTRACT

Objective: To determine pre hospital time (PHT) in our population and factors associated with this phenomenon Materials and Methods: This study was conducted at the Cardiology Department, Services hospital, Lahore.. One hundred and eighty five consecutive patients of acute ST segment elevation MI were recruited in this study. Both male and female patients of any age were included. Time from onset of symptoms till arrival at the hospital was noted for every patient and in case of delay the factors leading to this delay were inquired from every patient. Factors taken into consideration were, financial, long distance, lack of awareness, local general practitioners (GPs), no attendant at home, and others i.e. conveyance etc. Results: Mean age of the study population was 55±12 years, were male and were female. Among associated risk factors, smoking topped the list followed by hypertension 81(43.8%) and diabetes 52(28.1 0/0). The distribution of delay of presentation was as follows: 43.8% patients within 4 hours, 23.2% in 4Shours, 11.4% in 8-12 hours, 9.2% in 12-16 hours, 3.8% in 16-20 hours and 8.6% of patients presented to cardiac emergency more than 20 hours of the onset of symptoms. Anterior wall myocardial infarction was most frequent in our study whereas inferior wall MI was second in frequency 46(24.9%). Delayed presentation was observed more frequently in female population (72.72%). When clinical factors were taken into account, 58.02% hypertensives, 56.52% obese and 53.8% diabetics presented late. Local general practitioners were most frequent factor in 28% of 104 patients, followed by lack of awareness (10.8%). Long distance from emergency coronary care was a factor in 7.6% of the study population. Conclusion: The results of this population based study showed majority of the study population exhibited prolonged delay (>4 Hrs). Moreover local general practitioners and lack of awareness of ischemic symptoms were most common factors for pre-hospital delay. Pre hospital delay was much more frequent among female study population.