Abstract
It was 3:17 a.m. when a 56-year-old man
arrived at the emergency department,
diaphoretic, with his hand pressed tightly
against his chest. “It was just stress… I
thought it would pass,” he managed to say as
the stretcher rolled toward the monitor. By
that moment, his myocardial tissue had
already been suffering for more than two
hours. Two hours of coronary occlusion
without reperfusion, two hours of electrical
silence in tissue that could still have been
saved. When the electrocardiogram revealed
ST-segment elevation, we knew we were no
longer competing against disease, but
against time. And yet, even before deciding
between fibrinolysis or transfer for
angioplasty, we sensed that the system had
already delayed us. The race had been lost
before he crossed the door.