Prehospital Phase of Patients Admitted to a Coronary Care Unit

Abstract. The interval between onset of chest pain and admission to a Stockholm Coronary Care Unit (CCU) has been investigated in 137 patients, 42% of whom were in the CCU within 3 hours (median about 3½) of onset of symptoms. The main part of the interval was patient delay, 30% calling for help within 30 min, yet as many waiting for 3 hours or more before doing so. Of those seeking help within 30 min 85% were in the CCU within 3 hours of onset of symptoms. Almost half the patients sought help by calling the Central Health Information Centre and 84% of patients were sent to hospital without first being seen by a physician. The subsequent diagnosis, i.e. acute myocardial infarction or not, did not affect the delay. Factors in the past medical history associated with a shorter delay were “previous CCU care” and “visit to physician during last year”. Delay was also shorter for patients not at home at the time of onset of symptoms and for those who encountered a positive attitude when calling for medical help. For unknown reasons there were significantly more patients with anterior infarcts among those with a short delay. Sex, age and self‐diagnosis did not affect the delay.