Nearly a quarter of a million people each year in England and Wales suffer from an acute myocardial infarction (AMI) (Gerschlick 2001). Up to half of these will die within a month and over half of these deaths occur before the patient reaches hospital (NICE 2002a), many within the first few minutes of the onset of symptoms (DoH 2000a). It is well known that the chance of survival following an AMI is dramatically increased if treatment is initiated early. It is vital therefore that AMI is recognised promptly and treatment initiated immediately. This applies equally to patients who suffer AMI out of hospital and those who are already hospital inpatients.
• unstable angina
• non-ST elevation myocardial infarction (NSTEMI)
• ST elevation myocardial infarction (STEMI).
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