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

Autor:	Marcolino MS; 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., Santos TMM; MD. Radiology Resident, Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Stefanelli FC; MD. Radiology Resident, Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Oliveira JAQ; MSc. Pharmacist and Doctoral Student, Medical School and Telehealth Center, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., E Silva MVRS; Medical Student, Telehealth Center, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Andrade DF Júnior; MD. Radiology Resident, Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Silva GKME; Pharmacist, Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil., Ribeiro AL; MD, PhD. Full Professor, Department of Internal Medicine, Medical School, and Telehealth Center, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2017 Sep-Oct; Vol. 135 (5), pp. 481-487. Date of Electronic Publication: 2017 Nov 06.
DOI:	10.1590/1516-3180.2017.0090110617
Abstrakt:	Background: Electrocardiograms (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 Setting: Observational retrospective study assessing consecutive patients whose digital ECGs were sent for analysis to the team of the Telehealth Network of Minas Gerais. Methods: Data 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. Results: Over 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. Conclusion: In this study, cardiovascular emergencies were misdiagnosed in primary care settings, acute myocardial ischemia was the most frequent emergency and the mortality rate was high.
Databáze:	MEDLINE
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