Abstract
Aims: The aim of this study is to review and analyze the associated factors that contribute to delay in prehospital myocardial infarction, based on published literature.
 Methodology: A systematic literature review was conducted to identify and analyze the associated factors with delay in prehospital myocardial infarction (MI). Relevant studies published between 2003 and 2022 were searched using predefined search terms in electronic databases. Study selection involved screening titles and abstracts, followed by a full-text evaluation of potentially relevant articles. Data from selected studies were extracted and analyzed qualitatively to identify common patterns and associations. The quality of included studies was assessed using appropriate tools, and the findings were synthesized narratively.
 Results: Sociodemographic and clinical factors, such as older age, female gender, lower socioeconomic status, and comorbidities like diabetes and hypertension, were consistently associated with delayed presentation to healthcare facilities. Individuals with a history of psychiatric disorders, including depression and anxiety, were also more likely to experience delays in seeking medical attention for MI symptoms. Psychosocial and behavioral factors, such as fear, denial, low health literacy, and misconceptions about the seriousness of the condition, further impeded timely recognition and response. Additionally, system-level factors, including inadequate infrastructure, limited resources, and overcrowding in emergency departments, contributed to diagnostic delays.
 Conclusion: The delay in prehospital myocardial infarction (MI) diagnosis is a significant issue influenced by various factors. Sociodemographic, clinical, psychosocial, and system-level factors contribute to this delay. Addressing these factors through targeted interventions, education, and improved access to healthcare can help mitigate delays, improve timely recognition, and enhance outcomes for individuals experiencing MI.
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