DELAYED DIAGNOSIS AND ITS IMPACT ON ISCHEMIC HEART DISEASE MORTALITY: EVIDENCE FROM SAMARKAND AND GERMANY

Ischemic heart disease (IHD) is a major cause of mortality worldwide, and early diagnosis and appropriate therapeutic management are important for survival. This article conceptually compares a late diagnosis and its fatal outcomes regarding IHD in Samarkand (Uzbekistan) with those in Germany, based on available epidemiological data from local registries and published literature. Germany is a high-income country with well-developed emergency cardiac care and comprehensive surveillance, for which IHD mortality has been continuously declining, partially attributable to decreasing pre-hospital- and system-delays in the management of AMI. In contrast, high cardiovascular mortality and major obstacles to early detection or prevention of risk factors were reported from these data, especially in Samarkand. Data from international reports suggest that there is a marked increase in hospital and short-term mortality within STEMI when prehospital delay (PHD) and/or system delay (SD) are long. Combining these insights, the paper discusses how structural disparities in health systems, emergency care pathways, and public knowledge map into discrete IHD-mortality patterns in Samarkand and Germany, and suggests priority interventions to lower delay deaths.