THE ROLE OF REGIONAL URGENT CARDIOLOGY TELEMEDICINE SYSTEM: CLINICAL CASE OF SAVING LIFE IN PATIENT WITH FREDERICK SYNDROME.
Authors: Oleksandr Katerenchuk
A 77 years old female was admitted on 21-Dec-2012 to the district hospital in terminal condition. Patient loss its consciousness about 20 minutes ago. At the time of admission patient was unconsciousness with convulsive disorder and unstable haemodynamic. Pulse rate was about 18-20 per minute, blood pressure – 60/20 mm.Hg. Patient was examined by doctor on duty (who is not specialized in cardiology) and an ECG was transmitted by phone line (“Telecard” system provided by “Tredex” was used) to the central ECG-receiving station localized in SpecialisedCardiological Department of Urgent Care with Telemedicine Centre at Regional Clinical Cardiological Dispensary. (see picture 1).
ECG was immediately interpreted by cardiologist and Frederick syndrome was diagnosed (atrial fibrillation/ flutter combined with complete atrioventricular block). As it was no possibilities to provide temporary pacing on place the pharmacological treatment was recommended (i.e. atropine) and specialized cardiological team send to district hospital (120 km.abroad). 50 minutes after patients admission and 5 minutes after cardiological team arrival the transcutaneous pacing was started. Patient remains unconsciousness but the blood pressure was elevated to 120\80 mm.Hg. Patient was successfully transferred to Regional Clinical Hospital, where after the neurological examination the decision to implant an permanent pacemaker was made. Three days later patient was discharged in good condition.
This clinical case shows an importance of early detection of critical cardiovascular disturbances and the role of telemedicine (ECG-transmission) in immediate correct decision making.