Door in – door out time – Cardiology MCQ – Answer

Door in – door out time – Cardiology MCQ – Answer

Recommended door in – door out time in ST elevation myocardial infarction (STEMI) presenting to non-PCI center:

Correct answer:

1. Less than 30 minutes

Back to question
Door in door out time is applicable when a person presents with ST segment elevation myocardial infarction to a centre which does not have the facility to perform primary angioplasty. Primary angioplasty being the best option to open up the infarct related coronary artery, it has to be done at the earliest. So time should not be lost by undue observation at a non PCI (percutaneous coronary intervention) capable centre. When the person presents to the emergency department in such a centre with symptoms suggestive of acute coronary syndrome, an ECG should be taken and interpreted within 10 minutes. If STEMI is diagnostic, PCI capable centre should be contacted and the cath lab there alerted. Patient should be transferred to the PCI capable centre so that the sum total of transfer time and time to open up the vessel at the PCI capable centre should be less than 120 minutes. If this target is not achievable, door in door out time does not come into play and thrombolytic therapy should be administered if not contraindicated, from the initial centre itself. Later transfer may be considered for PCI between 3 hours to 24 hours in thrombolysed persons. Transfer will be considered in failed thrombolysis as well.