Delays in Cardiovascular Emergency Responses in Africa: Health System Failures or Cultural Challenges?

Delays in receiving care for debilitating cardiovascular emergencies, such as myocardial infarction and stroke, are multifaceted and include personal, systemic, and health facility-related factors, which must all be addressed to successfully improve cardiovascular emergency outcomes. Cardiovascular emergencies contribute significantly to morbidity and mortality in Africa, partly perhaps due to a combination of time-related delays in appreciating symptoms, getting to an intervention-capable facility, and prevailing emergency care systems. Drawing experiences from across Africa, we discuss unique limitations to prompt and appropriate management of cardiovascular emergencies in the African setting. Investing in multisectoral collaboration is required to improve the status quo of cardiovascular emergency care. Community education is important in ensuring that patients who suffer cardiovascular emergencies recognize their symptoms and take early steps to seek prompt, appropriate medical care. Well-defined emergency systems are required to facilitate the transport of patients with cardiovascular emergencies to appropriate hospitals. This involves improving road networks, training emergency responders, and having ambulances equipped with electrocardiograms and thrombolytic drugs, among others. These services should also be able to directly activate hospital emergency services before arrival, ensuring a seamless continuity of care. Health care providers on duty should be abreast with recognizing cardiovascular emergencies and the local avenues for optimal care, minimizing hospital-related delays in such patients.