Authors: Momar Dioum, Papa Guirane Ndiaye, Louise Héléne Ndiaye, Joseph Salavador Mingou, Saguinatou D. AW, Serigne Cheikh Tidiane Ndao, Mohamed Gazaal, Mouhamed C. Mboup, Maboury Diao.
Introduction: The management of ST Segment Elevation Myocardial Infarction (STEMI) in African environment is a real problem with many diagnostic and therapeutic delays. The objective of this study was to identify the factors that lengthen consultation times and to assess the overall management of patients received after the deadline.
Methodology: This was a multicentre, prospective, analytical and descriptive study from August 1st, 2021 to April 30th, 2022. Were included all patients with STEMI received after the 12th hour after the onset of pain in four cardiology centers in Dakar.
Results: Fifty patients were included, representing 11.21% of all the STEMI. The predominance was male (68%). The average age of patients was 56.74 years. The main risk factors identified were hypertension (46%), diabetes (42%), dyslipidemia (36%) and smoking (34%). Chest pain was the main symptom and occurred mainly between 8h and 22h in 72% of cases. The average time between pain onset and admission to cardiology was 134.22 hours. The reasons cited for the delay in consultation were related to the late onset of pain (32%), self-medication (28%), financial concern (20%), ignorance of severity (10%) and the fact that pain is tolerable (10%). The average time between first medical contact and ECG completion was 52.64 minutes. Coronary angiography in 35 patients (70%) had mostly triple-vessel disease (28%). PCI was done in 42% of patients. Overall, the evolution was favourable (88%). Two deaths were recorded during hospitalization, for a hospital mortality rate of 4%.
Conclusion: Delays in the diagnosis and management of STEMI are enormous with significant consequences. For a definitive solution to the various factors identified, it will be necessary to change the paradigm that will mainly involve awareness and communication and the creation of a coronary pathway
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