DefinePK

Abstract

Objectives: Timely reperfusion therapy within 12 hours of symptom onset is essential for myocardial salvage, improved left ventricular function, and reduced mortality in ST-segment elevation myocardial infarction (STEMI). However, up to 40% of patients present beyond 12 hours. This study aimed to identify factors contributing to delayed presentation.
Methodology: This single-center observational study was conducted over 10 months (November 2022–September 2023) at the National Institute of Cardiovascular Diseases. STEMI patients presenting >12 hours after symptom onset and undergoing cardiac catheterization were included. Data were collected through structured interviews and clinical assessments, focusing on reasons for delayed presentation and baseline characteristics.
Results: A total of 305 patients (78% male) with a mean age of 58.5 years (±10.8) were included. Chest pain (62%) was the primary indication for cardiac catheterization, followed by heart failure (8%). The main reasons for late arrival were misinterpretation of symptoms as gastric or muscular pain by patients or families (45%), misdiagnosis by general practitioners (22%), financial constraints (11.5%), and lack of transportation (9%).
Conclusion: Misinterpretation of symptoms and misdiagnosis by general practitioners are the most significant causes of delayed STEMI presentation. Mass education campaigns and targeted training programs for primary care physicians are necessary to reduce delays. Improved transportation infrastructure and policies promoting timely access to cardiac care can further mitigate morbidity and mortality associated with STEMI.