• Sao Paulo Med J · Sep 2017

    Observational Study

    Cardiovascular emergencies in primary care: an observational retrospective study of a large-scale telecardiology service.

    • Milena Soriano Marcolino, Thales Matheus Mendonça Santos, Fernanda Cotrim Stefanelli, João Antonio de Queiroz Oliveira, E SilvaMaíra Viana Rego SouzaMVRSMedical Student, Telehealth Center, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Diomildo Ferreira Andrade, Grace Kelly Matos E Silva, and Antonio Luiz Ribeiro.
    • MD, PhD. Adjunct Professor, Department of Internal Medicine, Medical School, and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
    • Sao Paulo Med J. 2017 Sep 1; 135 (5): 481487481-487.

    BackgroundElectrocardiograms (ECGs) are an essential examination for identification and management of cardiovascular emergencies.The aim of this study was to report on the frequency and recognition of cardiovascular emergencies in primary care units.Design And SettingObservational retrospective study assessing consecutive patients whose digital ECGs were sent for analysis to the team of the Telehealth Network of Minas Gerais.MethodsData from patients diagnosed with cardiological emergencies in the primary care setting of 750 municipalities in Minas Gerais, Brazil, between March and September 2015, were collected via telephone contact with the healthcare practitioner who performed the ECG. After collection, the data were subjected to statistical analysis.ResultsOver the study period, 304 patients with cardiovascular emergencies were diagnosed within primary care. Only 73.4% of these were recognized by the local physicians. Overall, the most frequent ECG abnormalities were acute ischemic patterns (44.7%) and the frequency of such patterns was higher among the ECGs assigned as emergency priority (P = 0.03). It was possible to obtain complete information on 231 patients (75.9%). Among these, the mean age was 65 ± 14.4 years, 57.1% were men and the most prevalent comorbidity was hypertension (68.4%). In total, 77.9% were referred to a unit caring for cases of higher complexity and 11.7% of the patients died.ConclusionIn this study, cardiovascular emergencies were misdiagnosed in primary care settings, acute myocardial ischemia was the most frequent emergency and the mortality rate was high.

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