Components of delay in the pre-hospital phase of acute myocardial infarction

One hundred sixty patients from a defined population with acute myocardial infarction were questioned about their activities before hospital arrival. Hospital arrival time was divided into prodromal period, patient decision time, lay consultation period, medical decision time and travel time. Forty-eight percent experienced prodromal chest pain before the acute onset of symptoms. The median hospital arrival time for all patients was 2 hours, 45 minutes. Hospital arrival time was significantly prolonged in patients experiencing an increase in the severity of angina pectoris, and in those with a physician decision time of more than 1 hour. Implications for intervention techniques are discussed.