Operation of cardiological outpatient clinic during 24 hour emergency service in Northern Greece

Hippokratia 1998, 2(1):22-27

A. Efthimiadis, N. Lefkos, I. Papadopoulos, G. Kazinakis, M. Hatzihasan


Abstract

The purpose of our study is the retrospective assessment of the cardiological outpatient clinic movement during a 24 hour emergency service in Northern Greece, according to the number of the patients who were examined, the urgent management applied; the way of the selection and the types of the admitted patient?s diseases. The cardiological outpatient clinic records were retrospectively studied the period from 8-6-1995 to 30-8-1996. The total number of the cardiological patients examined was 3321 (M = 1842, F = 1479, aged 14-99 years). A detailed medical history and a 12 lead ECG recording were obtained from all patients. The treatment of the severely ill patients (acute pulmonary oedema, shock etc) was started with their presentation at the outpatient clinic and continued at the coronary care unit. The main symptom was chest pain in the majority of the examined patients (2360) dyspnoea in 473, palpitation in 442 and syncope in 47. The diagnosis in the 1044 patients who were admitted (M = 578, F = 466, mean age 64.7?12.6 years) was ischaemic heart disease in 525, acute pulmonary oedema in 69, paroxysmal atrial fibrillation in 105, paroxysmal atrial tachycardia in 85, congestive heart failure in 75, valvulopathy in 40, atypical chest pain in 90, syncope in 20, acute or chronic pericarditis in 30, while in 5 pts dissection of the aorta was diagnosed. During the 24 hour emergency service the main tool contributing to the correct diagnosis and so the safe treatment and the proper choice of the patients needing hospitalization is the detailed medical history in combination with the proper use of the other diagnostic methods. Ischaemic heart disease is the most often reason for patients meeting the outpatient clinic during emergency service and the greater percentage of them are males. Women presenting acute myocardial infarction were 10 years older than men. Supraventricular tachycardias, particularly atrial fibrillation was the more frequent type of arrhythmias, while valvulopathies and pericarditis were less common reason for hospitalization.