[Managing STEMI before the hospital : let's identify our enemies!]

Abstract

Managing a patient with chest pain suspected to be a ST segment elevation myocardial infarction is a race against time. This management is based on a chain, like what is presented for cardiac arrest. Three phases follow one another, with potential loss of time successively attributable to the patient, the emergency physician and then the cardiologist. It would be tempting to consider that the main culprit in the event of delayed treatment is the patient. This review is the opportunity to show that it is not the case. The emergency physician, the cardiologist and their interconnection are the main providers of delay and, as such, the main enemies of myocardial reperfusion.

Keywords: acute coronary syndrome; cardiologie; cardiology; delays; délais; emergencies; prehospital; préhospitalier; reperfusion; syndrome coronaire aigu; urgences.