A blurred ambulance travels at speed past the Houses of Parliament in London.

Emergency response to heart attack

HSIB legacy content

HSIB legacy content

This investigation was carried out by the Healthcare Safety Investigation Branch (HSIB). Find out more about HSIB legacy.

National investigation

Our investigation looked at the emergency response to heart attack across the NHS in England.

There are different types of heart attack and this investigation looked into the most serious type – ST segment elevation myocardial infarction (STEMI). STEMI is what most people think of when they hear the term ‘heart attack’.

A person suffering from a heart attack (STEMI) requires a time critical response to ensure they receive the most appropriate medical intervention.

STEMI occurs when a clot forms in the blood vessel which serves the heart with oxygenated blood. The preferred treatment option for STEMI is primary percutaneous coronary intervention (PPCI). This is where a stent (wire mesh tube) is inserted into a blocked blood vessel in the heart, opening it up and re-establishing and maintaining blood flow.

If the clot is not removed or by-passed there is potential for further damage to the heart muscle or the patient having another heart attack.

Any delay in responding to a patient, or in transporting them to hospital, increases the risk of suffering additional harm.

Reference event

We started this investigation after a patient notified us of a delay in an ambulance attending him after suffering a heart attack (STEMI).

Investigation summary

This investigation:

  • Looked at the systemic safety issues relating to the emergency response to heart attack.
  • Examined treatment options available for patients who have suffered a heart attack (specifically STEMI).
  • Considered other systemic safety issues identified during the investigation.