A retrospective description of acute coronary syndromes presenting to prehospital providers in the Western Cape, South Africa

Diagnostic 12-lead electrocardiography (ECG) is central to clinical decision-making in patients presenting with ACS, and limited utilisation could affect activation of referral pathways and delay reperfusion, ultimately worsening clinical outcomes. Further research is required to assess competencies, governance frameworks, and the availability of equipment. Despite low cost and high efficacy, aspirin was administered sub-optimally, raising doubt about clinical guideline adherence or uncertainty in diagnostic capabilities.