Do not cause further delay by transferring the patient to a coronary care unit. Avoid having to call a consultant or specialist before starting treatment. The authority to initiate treatment should reside with the primary care physician in the emergency department. Summary An AMI is a medical emergency no less urgent than serious traumatic injury. A delay in reperfusion treatment condemns potentially viable myocardial tissue to death, and an uncertain fate lurks for the owner of that damaged heart.
Wonderful tools are at our disposal to restore coronary blood flow quickly.
We no longer have to passively contemplate the inexorable advance of the wave front of necrosis so elegantly described by Reimer and Jennings 2 decades ago. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Epidemiology of avoidable delay in the care of patients with acute myocardial infarction in Italy. Sabia PJ, Powers ER, Ragosta M, Sarembock IJ, Burwell LR, Kaul S, et al.