Background: Considering the prevalence of myocardial infarction (MI) and the importance of its early diagnosis in prevention of complications and life threatening conditions, this study was performed on patients admitted to Shaheed Beheshtee University Hospital at Kashan to determine the prevalence of delay in seeking treatment and to investigate the reasons for delay.
Materials and Methods: This descriptive, applied, study was performed on 200 patients suffering from MI. The relevant data such as age, gender, income, education, history of heart disease, the first referral center, the means of transfer to the hospital, the site where pain was first felt, the relevant signs and the amounts of delay were recorded in a questionnaire, and then were analyzed using statistical indices such as  x2, OR, CI.
Results: Of 200 studied patients, 138 (69%) were male of all patient 131 (56.5%) patients had referred late. The highest rate of delay was seen in women (n= 47 [75.8%]) (p 0.029), OR: 2.014. The older the patient, the longer the delay (p 0.0008) particularly, in the age range of 45-60 (n= 28 [54.1%]). The patients with lower education level (n = 73 [74.5%]) and lower income (n = 34 [79.1%]) had longer delay (p 0.01). Of all patients, 154 (77%) had been visited by a general practitioner prior to their referral, while only 46 (23%) had referred to the hospital directly. Out of 154, 137 (89%) had delay time longer than 8 hours 14.5% had called Emergency Medical Service (115) for seeking help,  (p 0.0254). and 85.5% used other means to reach the hospital. Moreover, the presence of signs like nausea, vomiting, shortness of breath, and headache related to chest pain were recorded in 88.4% of patients when they were admitted to the hospital. Punctual admission was more in patients with MI signs who lived in town, than those who were on the outskirts (60.7%). The onset of pain during the night made late referral (52.4%). Finally, the most common reasons for delay were the expectation of spontaneous relief (50%), considering noncardiac causes  and underestimating the patient which were more common in men (56.2%).
Conclusion: Considering the delay in the majority of patients (56.5%) and the significance of punctual admission to the hospital, the delay was due to the lack of awareness of the disease, patient’s low education level, and low income.