With the advent of thrombolytic therapy and other coronary reperfusion
strategies, rapid identification and treatment of acute myocardial in
farction greatly reduces mortality. Unfortunately, many patients delay
seeking medical care and miss the benefits afforded by recent advance
s in treatment. Studies have shown that the median time from onset of
symptoms to seeking care ranges from 2 to 61/2 hours, while optimal be
nefit is derived during the first hour from symptom onset. The phenome
non of delay by AMI patients and those around them needs to be underst
ood prior to the design of education and counseling strategies to redu
ce delay. In this article the literature is reviewed and variables tha
t increase patient delay are identified. A theoretical model based on
the health belief model, a self regulation model of illness cognition,
and interactionist role theory is proposed to explain the response of
an individual to the signs and symptoms of acute myocardial infarctio
n. Finally, recommendations are made for future research.