{"id":5248,"date":"2025-10-27T10:57:53","date_gmt":"2025-10-27T08:57:53","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=5248"},"modified":"2026-05-05T14:24:46","modified_gmt":"2026-05-05T12:24:46","slug":"cvja-2025-078","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2025-078\/","title":{"rendered":"A retrospective description of acute coronary syndromes presenting to prehospital providers in the Western Cape, South Africa"},"content":{"rendered":"    <div id=\"article\">                                                                                                                        \r\n        <div id=\"title-container\">                                                                                                    \r\n        <div id=\"authors-title\">                                                                                                            \r\n        <!--Aurthors under Title-->                                                                                                            \r\n            \r\nLynch Andrew, Stassen Willem\r\n        <\/div>        \r\n<\/div>                                                                                                                            \r\n            <div id=\"copyright\">\r\n        <strong>Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n        of Cardiovascular Journal of Africa.<\/div>\r\n    <div style=\"clear: both;\"><\/div>                                                                                                                                \r\n        <div id=\"article-abstract\">                                                                                                            \r\n            <div id=\"abstract-title\">                                                                                                        \r\n                    Abstract                                                                                                                \r\n                <\/div>                                                                                                                        \r\n                                                                                                                                \r\n            <div id=\"abstract-content\">                                                                                                        \r\n            <!--Content of Abstract Article-->                                                                                                \r\n            <!--<strong>\"Abstract titles\":<\/strong>-->                                                                                        \r\n            <!--<br\/> at the end of each section!!-->                                                                                        \r\n                                                                                                                                            \r\n        <strong>Introduction:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThe growing prevalence of cardiovascular disease (CVD) in Africa remains a significant public health and socioeconomic issue. Disease manifestations include acute coronary syndrome (ACS) and, crucially, ST-segment myocardial infarction (STEMI), predominantly resulting in serious or long-term complications often overburdening healthcare systems. Comprehensive treatment strategies emphasising timely reperfusion of infarct-related arteries remain a crucial step in the management of acute coronary care. To achieve this, incidents of ACS - and specifically STEMI need to be described, especially considering settings where time to reperfusion might have been delayed significantly. The aim was to identify and detail incidents of ACS in the prehospital setting, specifically in the Western Cape, South Africa.<br \/>                                                                                                                            \r\n        <strong>Methods:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThe study comprised a retrospective chart review of prehospital electronic patient care reports over a 12-month period (1 January 2018 to 31 December 2018). A provincial government emergency medical service (EMS) was sampled. Reports were analysed and descriptively summarised with eligibility criteria based on clinical findings indicative of ACS.\r\n<br \/>  \r\n                \r\n                <strong>Results:<\/strong>                                                                                                    \r\nA total of 975 ACS cases were included in the study. Extracted data were representative of a proportion of higher acuity cases, comprising red code (n = 869, 89.1%) and orange code (n 106, 10.9%) patient groups. STEMI was identified in 43 (4.4%) of cases, although deemed attributable to poor utilisation of electrocardiograms (ECGs) in order to support diagnosis, with no findings recorded in 787 (80.7%) of cases. Following STEMI diagnosis, aspirin was administered in fewer than half of all cases (n = 17, 39.5%).\r\n<br \/>\r\n                                                                                                                                                                                                                                                                        \r\n                                                                                                                                                \r\n        <strong>Conclusion:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nDiagnostic 12-lead electrocardiography (ECG) is central to clinical decision-making in patients presenting with ACS, and limited utilisation could affect activation of referral pathways and delay reperfusion, ultimately worsening clinical outcomes. Further research is required to assess competencies, governance frameworks, and the availability of equipment. Despite low cost and high efficacy, aspirin was administered sub-optimally, raising doubt about clinical guideline adherence or uncertainty in diagnostic capabilities.\r\n<br \/>    \r\n                                                                                                        \r\n\r\n                                                                                                                                                \r\n            <\/div>                                                                                                                            \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                        \r\n                                                                                                                                                \r\n        <div id=\"keywords\">                                                                                                                    \r\n                                                                                                                                            \r\n            <strong>Keywords:<\/strong>                                                                                                        \r\n                                                                                                                                            \r\n            <strong>cardiovascular disease, ST-segment myocardial infarction, reperfusion, percutaneous coronary intervention, thrombolytic therapy, South Africa<\/strong>                                                                                                                                                                                                                    \r\n                                                                                                                                                \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                                \r\n    <div id=\"publish-info\">                                                                                                                    \r\n                                                                                                                                \r\n    <strong>Submitted:<\/strong> July 8, 2024; <!--Month day, year; -->    \r\n    <strong>Accepted:<\/strong> July 24, 2025; <!--Month day, year; -->                                                                            \r\n    <strong>Published:<\/strong> October 27, 2025<!--Month day, year; -->                                                                                                                            <br \/>                                                            \r\n        <em>Cardiovasc J Afr 2025; <b>36<\/b>: 548-557<!--pg no. till pg no. \"eg. 4-7\"--><\/em>\r\n        <br \/><strong>Volume 36, Issue 4<\/strong> <br \/>                                                                            \r\n        <\/div>                                                                                                                            \r\n                                                                                                                                        \r\n    <div id=\"DOI\">                                                                                                                    \r\n            DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2025-078<!--DOI number-->                                                                \r\n        <\/div>                                                                                                                            \r\n                \r\n                <div id=\"author-affiliation\">                                                                                                \r\n\r\n<strong>School of Nursing and Paramedic Science, Ulster University, Derry-Londonderry, United Kingdom\r\n<\/strong>    <br \/>                                                                            \r\nLynch Andrew\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Division of Emergency Medicine,University of Cape Town, Cape Town, South Africa\r\n<\/strong>    <br \/>                                                                            \r\nLynch Andrew<br \/>\r\nStassen Willem\r\n\r\n<br \/><br \/>\r\n                                                                                                                                                                                                                                        \r\n\r\n                [soshsc hide=\"logged\"]\r\n                <strong>You need to be <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/member-login\/\" target=\"_blank\" rel=\"noopener\">logged in to view and download<\/a> the full text PDF version. <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/register\/\" target=\"_blank\" rel=\"noopener\">Register for a free account?<\/a><\/strong> <br \/><br \/>[\/soshsc]\r\n                \r\n                \r\n                \r\n                <\/div>\r\n    \r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>The growing prevalence of cardiovascular disease (CVD) in Africa remains a significant public health and socioeconomic issue. Disease manifestations include acute coronary syndrome (ACS) and, crucially, ST-segment myocardial infarction (STEMI), predominantly resulting in serious or long-term complications often overburdening healthcare systems.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[44,108],"tags":[],"class_list":["post-5248","post","type-post","status-publish","format-standard","hentry","category-cardiovascular-topics","category-volume-36-issue-4"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>A retrospective description of acute coronary syndromes presenting to prehospital providers in the Western Cape, South Africa - Cardiovascular Journal of Africa<\/title>\n<meta name=\"description\" content=\"The growing prevalence of cardiovascular disease (CVD) in Africa remains a significant public health and socioeconomic issue. Disease manifestations include acute coronary syndrome (ACS) and, crucially, ST-segment myocardial infarction (STEMI), predominantly resulting in serious or long-term complications often overburdening healthcare systems.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cvja.co.za\/journal\/cvja-2025-078\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A retrospective description of acute coronary syndromes presenting to prehospital providers in the Western Cape, South Africa - Cardiovascular Journal of Africa\" \/>\n<meta property=\"og:description\" content=\"The growing prevalence of cardiovascular disease (CVD) in Africa remains a significant public health and socioeconomic issue. 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