1. American Heart Association. Available at http://www.americanheart.org/statistics/07other.html. Accessed February 2000.http://www.americanheart.org/statistics/07other.html Epidemiology of Acute Myocardial Infarction (AMI) Incidence: 1.1 million people/y in the United States Of these: –At least one half die within 1 hour of symptom onset or before reaching the hospital –24% of men and 42% of women die within 1 year –66% fail to achieve full recovery –21% of men and 30% of women develop congestive heart failure within 6 years A 1% reduction in mortality would save 3,400 lives per year

2. World Health Organization. 1999 World Health Organization Report on Leading Causes of Mortality and Burden of Disease. AMI: Public Health Issues Ischemic heart disease (IHD) is the leading cause of death worldwide (7.4 million/y) IHD accounts for 13.7% of all deaths A 1% reduction in worldwide mortality would result in >73,000 lives saved per year

3. PTCA, percutaneous transluminal coronary angioplasty. 5.0%- 6.5% 13%-15% 30% Defibrillation Hemodynamic monitoring  -Blockade Defibrillation Hemodynamic monitoring  -Blockade Aspirin, PTCA, Lysis Aspirin, PTCA, Lysis Bed rest Pre-CCU EraCCU EraReperfusion Era Improvement in Mortality

4. Atypical Presentations Patients older than 75: frequently no chest pain ECG in evolution (nonspecific ECG changes) Diabetic patients: commonly no chest pain Stuttering chest pain Previous AMI Atypical symptoms