[Acute Heart Care: what happens with patients who are not immediately hospitalized?]

The clinical course of the first six weeks after discharge after consultation was studied in 527 patient contacts in 460 patients who were evaluated for acute cardiac symptoms in a six-month period at the acute cardiac care facility 'Eerste Harthulp' in the Academic Medical Centre. Analysis revealed that the initial diagnosis of acute ischaemia (261 cases) was correct in 118 (45%) and the initial diagnosis of arrhythmia (114 cases) in 92 (81%). In 220 patients there was no cardiac history; in those instances the initial diagnosis of acute ischaemia was confirmed in only 40% but the initial diagnosis of arrhythmia in 78%. Three patients died within six weeks after evaluation and 28 patients were admitted within that period. Patients without cardiac history and without a clear cardiac diagnosis consulted their general practitioner moderately frequently in the first six weeks and used specialist care only rarely.