Authors: Papa Guirane Ndiaye, Momar Dioum, Pape MD Fall, Joseph S Mingou, Cheikh MBM Diop, Mohamed Gazal, Aymard Abadassi, Cheikh T Ndao, Cherif Mboup, Bouna Diack, Mouhamadou B Ndiaye, Maboury Diao.
Introduction: Myocardial infarction (MI) is the most serious form of coronary artery disease with its dramatic consequences both functionally and prognostically. The management of this disease, as always stated, is a race against the clock. The objective of this study was to evaluate the diagnostic and management delays of patients with MI in the city of Dakar and its suburbs.
Methodology: This is a prospective, cross-sectional, descriptive and analytical study over a period of 06 months from April 1st, 2023 to September 31th, 2023. All patients admitted to the four major cardiology departments in Dakar for MI were included. Data were entered with the Kobotoolbox software and analyzed using SPSS software (p < 0.05).
Results: One hundred and fifty-nine patients were collected. Chest pain was the main symptom. The mean time between pain onset and first medical contact was 10.57 hours with extremes of 30 min and 144 hours. The mean time between first medical contact and completion of the first ECG was 129.23 min with extremes of 2 min and 6912 min, or 115,2 H. On average, 35.78 H was required between the onset of pain and patient admission to a cardiology centre. The mean time between pain onset and admission in cath lab was 45.34 H with a minimum delay of 2 hours and a maximum delay of 432 hours. Thrombolysis was performed in 51 patients (32%). Only one patient had a thrombolysis within 2H of pain onset, in 17 patients it was performed between H2 and H6 and in 29 patients between H6 and H12. The rate of completion of angioplasty was 38.2% with 24.2% primary coronary intervention. The mean angioplasty delay was 27.45 H with extremes of 2H and 144H. The outcome was mostly favorable, with complications of renal failure (40.6%), heart failure (11.4%) and cardiogenic shock (7.6%). The total number of deaths was 17, representing a hospital mortality rate of 10.8%.
Conclusion: Myocardial infarction, a global scourge, is characterized in our countries by significant delays in diagnosis and management. To correct these delays, which have a serious impact on the prognosis of this disease, more communication and awareness is needed.
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