Cardiovascular diseases and electrocardiogram teletransmission aboard ships: the French TMAS experience.

BACKGROUND: The aim of this study was to analyse emergency calls for teleconsultation received at French TMAS relating to cardiovascular pathologies, to assess the relevance of electrocardiogram teletransmission.

MATERIAL AND METHODS: A two-year descriptive and retrospective study from the TMAS medical files database. We selected patients whose telemedical request was related to a possible cardiovascular pathology. The French TMAS receives calls from all kinds of ship (passenger or merchant vessel), and our analysis was conducted by comparing passengers and professional seamen. On board, the caregiver performs the ECG after medical prescription and sends it by satellite to the TMAS.

RESULTS: A total of 179 cases of cardiovascular disease were selected, including 79 passengers (PG) (44.1%) and 89 professional seafarers (PS) (49.7%). In 11 cases (6.1%) patient status was not specified. The most frequent diagnoses were chest pain (58 cases) and STEMI (23 cases), followed by NON STEMI (21 cases). An ECG was performed in 70% of cases of chest pain. ECG diagnosed 23 STEMI, and all these patients had been evacuated by a medical team. This diagnosis led to the establishment of antithrombotic therapy. The mortality rate due to cardiovascular diseases was 9.5%. Ten occurred on board and 7 during the evacuation of the patient. Eleven were passengers and 6 were professional seamen.

CONCLUSIONS: Calls regarding cardiovascular disease are infrequent but require an effective response. Recording and transmitting an ECG to the TMAS is technically feasible and enables treatment to be started with specific drugs, mainly in the management of STEMI.