Description
An acute coronary syndrome usually starts with plaque rupture and should end with the patient leaving hospital with most of the myocardium still intact. With the way we run things in this country this Utopian ideal is rarely met. From the moment that the chest pain first starts to take a grip we have built in delays that are likely to lead to a poor outcome. The medical fraternity cannot be held responsible for many patients thinking they have indigestion and not picking up the telephone, but once the 999 call has been made the system, not the clot, starts to dissolve into chaos. Ambulance response times are terrible. Once the paramedics do arrive they often ‘stay and play’ rather than delivering the patient rapidly to the nearest hospital. This wouldn’t matter if thrombolysis could be delivered in transit, which has been commonplace on the Continent for some time, but in the UK this is considered far too dangerous. Even a 12-lead ECG is out of the question.
