L'article du mois
septembre 2011
Cardiovascular Emergencies in Cruise Ship Passengers
Gian M. Novaro,
MD*, Howard S. Bush, MD, Kenneth R. Fromkin, MD, Michael
Y. Shen, MD, Marcelo Helguera, MD, Sergio L. Pinski, MD,
and Craig R. Asher, MD
Am J Cardiol 2010;105:153–157
More than 10
million people, many elderly and likely to harbor
cardiovascular (CV) disease, embark on cruise ship
travel worldwide every year. The clinical presentation
and outcome of CV emergencies presenting during cruise
ship travel remain largely unknown. Our department
provides contracted cardiology consultations to several
large cruise lines. We prospectively maintained a
registry of all such consultations during a 2-year
period. One hundred consecutive patients were identified
(age 66
14 years,
range 18 to 90, 76% men). The most common symptom was
chest pain (50%). The most common diagnosis was acute
coronary syndrome (58%; ST elevation in 21% and non-ST
elevation in 37%). On-board mortality was 3%. Overall,
73% of patients required hospital triage. Of the 25
patients triaged to our institution, 17 underwent a
revascularization procedure. One patient died. Ten
percent of patients had cardiac symptoms in the days or
weeks before boarding; all required hospital triage.
Access to a baseline electrocardiogram would have been
clinically useful in 23% of cases. In conclusion, CV
emergencies, such as acute coronary syndrome and heart
failure, are not uncommon on cruise ships. They are
often serious, requiring hospital triage and coronary
revascularization. A pretravel medical evaluation is
recommended for passengers with a cardiac history or a
high-risk profile. Passengers should be encouraged to
bring a copy of their electrocardiogram on board if
abnormal. Cruise lines should establish mechanisms for
prompt consultation and triage.
Etude sociologique sur
les accidents du travail et les maladies
professionnelles dans les secteurs de la pêche et des
cultures marines en Bretagne
Véronique Daubas-Letourneux
Etude réalisée pour la Direction
Régionale des Entreprises, de la Concurrence, de la
Consommation, du Travail et de l'Emploi de Bretagne –
Programme 111 exercice 2010 Bretagne Action 1 santé et
sécurité au travail - Convention n° 2010 / 111-1-01
Accéder à l'étude
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