THE PROBLEMS OF INTERACTION BETWEEN PRE-HOSPITAL AND HOSPITAL STAGES WITH SUSPECTED ACUTE CORONARY SYNDROME IN REAL LIFE

The aim of the study was to study the results of treatment in primary vascular center of patients with suspected acute coronary syndrome (ACS). The study included 543 patients with suspected ACS, delivered by emergency medical service or who applied consistently for 3 months to the primary vascular center and 10 patients with myocardial infarction, hospitalized initially with other diagnoses. The results of electrocardiographic study, studies of markers of myocardial necrosis, coronary angiography, the proportion of hospitalization, 30-day outcomes and cases of repeated inpatient contact were evaluated. Low diagnostic capabilities of the hospital’s receiving department, which does not have an emergency department, in relation to the risk assessment of the patient with chest pain were revealed. Low possibilities of hospitalization of patients with suspected ACS have been established, which leads to delayed hospitalization and mortality of non-hospitalized patients at home. Errors in the diagnosis of myocardial infarction at the prehospital stage lead to diagnostic errors in the hospital. More frequent use of qualitative evaluation of myocardial necrosis markers at the prehospital stage is suggested as ways of solving the problems.

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