Cardiovascular emergencies in cruise ship passengers

Area of Science:

• Cardiology
• Public Health
• Travel Medicine

Background:

• Millions travel by cruise ship annually, including many elderly individuals with pre-existing cardiovascular disease.
• The clinical characteristics and outcomes of cardiovascular emergencies during cruise ship travel are not well-documented.
• Cardiology consultations are provided to major cruise lines, offering a unique opportunity to study these events.

Purpose of the Study:

• To investigate the incidence, presentation, and outcomes of cardiovascular emergencies occurring during cruise ship voyages.
• To identify key diagnoses, interventions, and mortality rates associated with these onboard medical events.
• To provide recommendations for pre-travel preparation and onboard medical management for passengers with cardiovascular conditions.

Main Methods:

• A prospective registry of cardiology consultations was maintained over a 2-year period.
• One hundred consecutive patients experiencing cardiovascular emergencies were identified and analyzed.
• Data collected included patient demographics, symptoms, diagnoses, treatments, and outcomes, including hospital triage and mortality.

Main Results:

• The study identified 100 patients (mean age 66 years, 76% male) with cardiovascular emergencies.
• The most common symptom was chest pain (50%), and the most frequent diagnosis was acute coronary syndrome (58%).
• Onboard mortality was 3%, with 73% requiring hospital triage; 17 of 25 triaged patients underwent revascularization.

Conclusions:

• Cardiovascular emergencies are common and serious on cruise ships, necessitating prompt medical attention and often hospital transfer.
• A pre-travel medical evaluation is advised for passengers with cardiac history or risk factors.
• Onboard electrocardiogram availability and prompt consultation mechanisms are crucial for managing these events effectively.