Cardiac emergencies in the emergency department after the 2020 earthquake – Croatian experiences.

Introduction: In 2020 Croatia was stuck with two major earthquakes: on March 22^nd with epicenter 7 km north of Zagreb city centre and on 29^th December with epicenter 5 km south of city of Petrinja (5.5 and 6.2 degrees on the Richter scale respectively). The authors sought to investigate whether these events had an influence on characteristics and number of patients with cardiac chief complaints examined in the Emergency Departments (ED)^1,2. Patients and Methods: Data on all emergency visits of patients with cardiac chief complaint examined in two University Hospital Centres (UHC) (Sestre Milosrdnice UHC, Zagreb and Zagreb UHC, Zagreb), two University Hospitals (UH) (“Sveti Duh UH, Zagreb and “Merkur” UH, Zagreb) and two regional hospitals (Sisak General Hospital, Sisak and Karlovac General Hospital, Karlovac) examined 7 days prior to earthquake, on the day of each earthquake, and during subsequent 6 days were collected. Results: In the examined period, there were 5575 ED visits (average age 66 years, female gender 45%), out of which in 1251 (22.4%) cases the chief complaint was cardiac. While in all patients seen after the earthquake only more often primary cardiac diagnosis found was non-anginal chest discomfort (28.8% vs 18.0%; p<0.001), when narrowed down the patients group to only the ones who were located within the 20 kilometers from the epicenter we found that there was significantly more patients with acute myocardial infarction (14.5% vs 22.8%; p= 0.028), acute elevation of blood pressure (10% vs 21.8%, p= 0.001), as well as more paroxysmal arrhythmias treated with electrocardioversion (0.9% vs 4.5%, p=0.022) (Table 1). Conclusion: In this study, increment in the frequency of cardiac emergencies was detected after a moderate earthquake in patients who were within 20 kilometers of the epicenter. They had significantly more often acute myocardial infarction, acute elevation of blood pressure, as well as paroxysmal arrhythmias treated with electrocardioversion. The health system should be prepared to treat a larger number of cardiac patients in difficult conditions after the earthquake. [ABSTRACT FROM AUTHOR]