Causes of Late Referral to the Emergency Department in Patients with Myocardial Infarction in Iran

• Published in: Acta Facultatis Medicae Naissensis 2018-06, Vol.35 (2), p.105-113
• Main Authors: Rad, Mojtaba, Bidi, Akram, Khaligh, Gholam Reza, Rad, Mostafa
• Format: Article
• Language: English
• Subjects: Electrocardiography; emergency; Emergency medical care; Heart attacks; late referral; Medical referrals; myocardial infarction; Pain
• ISSN: 2217-2521; 0351-6083; 2217-2521
• DOI: 10.2478/afmnai-2018-0012

Late referral of patients with myocardial infarction is one of the main causes of morbidity or mortality in these patients. Therefore, this study aimed to investigate the factors involved in the late referral of patients with heart attacks to the emergency department. A descriptive cross-sectional study was conducted on 148 patients with myocardial infarction referred to the emergency department. They were chosen using a census method. A researcher-made questionnaire was developed and assessed in terms of validity and reliability for data collection. Inclusion criteria included suffering from chest pain or other symptoms indicative of acute myocardial infarction, age above 18 years, tendency to take part in this study, patients with acute myocardial infarction who had late referral and were admitted to cardiac care unit for at least 48 hours. Data was analyzed using descriptive and inferential statistics via SPSS software. P < 0.05 denoted statistical significance. Pain improvement with rest (85.8%), severity of chest pain and lack of familiarity with the symptoms of heart diseases and abnormal cardiac symptoms (87.8%), confusion of heart problems with musculoskeletal problems (70.2%), and the presence of concomitant diabetes were important factors influencing late referral to the emergency department. The average time to reach the emergency department after the onset of the heart problem was 24 ± 3 hours. A lack of patients’ familiarity with cardiovascular symptoms and acute myocardial infarction calls the need to educate the society about symptoms and the need for an early referral to healthcare settings.