Timely reperfusion

Quality Statement 3

A patient with an acute ST-segment-elevation myocardial infarction (STEMI), for whom emergency reperfusion is clinically appropriate, is offered timely percutaneous coronary intervention (PCI) or fibrinolysis in accordance with the time frames recommended in the current National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes. In general, primary PCI is recommended if the time from first medical contact to balloon inflation is anticipated to be less than 90 minutes; otherwise, the patient is offered fibrinolysis.

Purpose

To ensure that patients who are eligible for primary PCI or fibrinolysis are offered treatment within time frames recommended in current guidelines.

For consumers

If you have a heart attack in which the artery supplying an area of the heart muscle is completely blocked, your doctor decides whether you can have a procedure called PCI. In a PCI, a heart specialist passes a fine probe through an artery to your heart and inflates a small balloon that aims to ease the blockage. If a PCI cannot be provided within an appropriate time frame, you may be given a medicine that dissolves blood clots. This is done urgently. Your doctor will discuss your treatment with you so that you understand the risks and benefits, and can provide your consent.

For clinicians

Offer primary PCI or fibrinolysis to all eligible patients diagnosed with an acute STEMI, within the time frames recommended in the current Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes. Ensure that the patient understands the risks and benefits of their proposed treatment, and provides their consent.

For health service organisations

Ensure that systems and processes are in place for clinicians to offer primary PCI or fibrinolysis to all eligible patients diagnosed with an acute STEMI within the time frames recommended in the current Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes.

For consumers

If you have a heart attack in which the artery supplying an area of the heart muscle is completely blocked, your doctor decides whether you can have a procedure called PCI. In a PCI, a heart specialist passes a fine probe through an artery to your heart and inflates a small balloon that aims to ease the blockage. If a PCI cannot be provided within an appropriate time frame, you may be given a medicine that dissolves blood clots. This is done urgently. Your doctor will discuss your treatment with you so that you understand the risks and benefits, and can provide your consent.

For clinicians

Offer primary PCI or fibrinolysis to all eligible patients diagnosed with an acute STEMI, within the time frames recommended in the current Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes. Ensure that the patient understands the risks and benefits of their proposed treatment, and provides their consent.

For health service organisations

Ensure that systems and processes are in place for clinicians to offer primary PCI or fibrinolysis to all eligible patients diagnosed with an acute STEMI within the time frames recommended in the current Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes.

Read Quality Statement 4 - Risk stratification