Abstract 41: Incidence of Cardiovascular Emergencies During Cardiac Tests
Background: Cardiovascular major events are infrequent during cardiac testing. In Brazil, cardiologic tests are performed in hospitals and outpatient diagnostic centers. One of the most important outpatient diagnostic centers in Sao Paulo, the most populous city in Brazil, is Fleury Medicine and Health (FMH). In average, 150 thousand cardiac tests are performed annually at FMH. Our objective was to analyze the incidence of cardiovascular emergencies during cardiac tests.
Methods: During a 14-month period (January 2013 to February 2014), were prospectively collected all severe cardiovascular emergencies while performing cardiac tests at FMH. Serious cardiovascular emergencies were defined as those where the patient required transfer to hospital center to continue treatment.
Results: During this period 172,567.00 cardiac tests were performed in FMH, from them, 43% correspond to exercise testing, 29% transthoracic echocardiograms and 26% electrocardiograms . Forty four cardiovascular emergencies were reported, incidence of 2.5 in 10,000 patients. The mean age was 62 ± 13 years and 25(74%) were male. The highest number of emergencies happened during exercise testing (47%) and less frequent during, echocardiogram and electrocardiogram (20% and 15% respectively). The most frequent diagnosis were myocardial ischemia in 44% and cardiac arrhythmias in 35% of patients. Two patients (6%) presented acute myocardial infarction with ST elevation, one of them evolving rapidly to ventricular tachycardia and subsequently to ventricular fibrillation. The patient returns of spontaneous circulation after cardiopulmonary resuscitation (CPR) and transferred to a tertiary hospital, Coronary Angioplasty was performed and patient was discharged without neurological damage. Patient’s follow-up showed that all patients were discharged after medical or surgical treatment.
Conclusion: Cardiovascular emergencies are infrequent in outpatient centers. Although rare, these complications during cardiac tests could be fatal. We reinforce the importance of conducting cardiac tests by health professionals with knowledge of possible complications, appropriately trained in CPR and in settings properly equipped with defibrillator and medications.
- Myocardial infarction, STEMI
- Ventricular tachycardia
- Ventricular fibrillation
- Exercise tests
Author Disclosures: M. Gonzalez: None. I. Antelmi: None. F.J. Mancuso: None. V.A. Moises: None. D.B. Kerbauy: None. J.M. Tsutsui: None.
- © 2014 by American Heart Association, Inc.