open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28
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Original article
Acute coronary syndrome – how to reduce the time from the onset of chest pain to treatment?

Maria Walkiewicz, Dorota Krówczyńska, Urszula Kuchta, Mariola Kmiecicka, Paweł Kurjata, Janina Stępińska
Kardiol Pol 2008;66(11):1163-1170.

open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28

Abstract


Background: Enormous progress in treating acute coronary syndrome (ACS) and shortening the time between the onset of pain and intervention has been made in recent years. However, the time from the beginning of pain to the call for help is still too long.
Aim: To establish the causes of delayed call for help by ACS patients and to answer the question how to shorten that time. An additional aim was to examine the knowledge about myocardial infarction (MI) among patients with ACS.
Methods: The study group consisted of 349 patients treated for ACS at the CCU. Nurses interviewed the patients using a questionnaire focused on demographic data, ACS characteristics, risk factors and situations which occurred between pain onset and arrival at the CCU. The data were analysed in relation to sex, place of living, education level, professional activity, history of MI, diabetes, and hypertension.
Results: The time between the onset of symptoms and the call for medical help ranged from 4 to 1140 min. The longest delay was reported by patients aged 56-70 years. Half of them called for help later than after 3 hours. Women waited longer than men. They also waited longer for an ambulance &#8211; 20 vs. 15 min (p <0.01). Professionally active patients called for help sooner: 82.7 vs. 120.2 min (p=0.02). Warsaw inhabitants waited longer than those living in other towns and in rural areas (p=0.04). The main causes of delay were: being confident that symptoms would subside (201 patients &#8211; 57.6%), or that the symptoms were not associated with heart disease (45 patients &#8211; 12.9%). The 41.5% of patients knew what MI was, 37.2% were familiar with features of ischaemic chest pain. Symptoms of pain were known to 44.4% of patients with ACS history vs. 32.2% of previously untreated (p=0.02), blood pressure levels were known to 51.4 vs. 45.4% (NS), and cholesterol to 29.9 vs. 20.0% (p=0.03). A general practitioner was mentioned as the source of information by 44.4% of patients and a nurse &#8211; by 11.5%.
Conclusions: The main cause of delayed call for help in ACS patients was a poor level of knowledge about MI, risk factors and management at the time of chest pain onset. Education concerning these issues should be started at school. Physicians, nurses and media should participate in the education.

Abstract


Background: Enormous progress in treating acute coronary syndrome (ACS) and shortening the time between the onset of pain and intervention has been made in recent years. However, the time from the beginning of pain to the call for help is still too long.
Aim: To establish the causes of delayed call for help by ACS patients and to answer the question how to shorten that time. An additional aim was to examine the knowledge about myocardial infarction (MI) among patients with ACS.
Methods: The study group consisted of 349 patients treated for ACS at the CCU. Nurses interviewed the patients using a questionnaire focused on demographic data, ACS characteristics, risk factors and situations which occurred between pain onset and arrival at the CCU. The data were analysed in relation to sex, place of living, education level, professional activity, history of MI, diabetes, and hypertension.
Results: The time between the onset of symptoms and the call for medical help ranged from 4 to 1140 min. The longest delay was reported by patients aged 56-70 years. Half of them called for help later than after 3 hours. Women waited longer than men. They also waited longer for an ambulance &#8211; 20 vs. 15 min (p <0.01). Professionally active patients called for help sooner: 82.7 vs. 120.2 min (p=0.02). Warsaw inhabitants waited longer than those living in other towns and in rural areas (p=0.04). The main causes of delay were: being confident that symptoms would subside (201 patients &#8211; 57.6%), or that the symptoms were not associated with heart disease (45 patients &#8211; 12.9%). The 41.5% of patients knew what MI was, 37.2% were familiar with features of ischaemic chest pain. Symptoms of pain were known to 44.4% of patients with ACS history vs. 32.2% of previously untreated (p=0.02), blood pressure levels were known to 51.4 vs. 45.4% (NS), and cholesterol to 29.9 vs. 20.0% (p=0.03). A general practitioner was mentioned as the source of information by 44.4% of patients and a nurse &#8211; by 11.5%.
Conclusions: The main cause of delayed call for help in ACS patients was a poor level of knowledge about MI, risk factors and management at the time of chest pain onset. Education concerning these issues should be started at school. Physicians, nurses and media should participate in the education.
Get Citation

Keywords

acute coronary syndromes; patients’ presentation after chest pain onset; education

About this article
Title

Original article
Acute coronary syndrome – how to reduce the time from the onset of chest pain to treatment?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 11 (2008)

Pages

1163-1170

Published online

2008-11-27

Bibliographic record

Kardiol Pol 2008;66(11):1163-1170.

Keywords

acute coronary syndromes
patients’ presentation after chest pain onset
education

Authors

Maria Walkiewicz
Dorota Krówczyńska
Urszula Kuchta
Mariola Kmiecicka
Paweł Kurjata
Janina Stępińska

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