title: Cardiovascular events on board commercial maritime vessels: a two-year review.
abstract: BACKGROUND
  Cardiovascular diseases (CVDs) are an important concern in merchant maritime operations. They are responsible for the majority of deaths at sea that are not related to injury or violence. The objective was to better understand the epidemiology of CVD in merchant maritime operations.
  
  
  METHODS
  Retrospective review of medical events on board merchant maritime vessels over a period of two years, from a US-based telemedicine provider's database.
  
  
  RESULTS
  A total of 1,394 cases were initially retrieved from the database. CVD was diagnosed in 29 cases and was the eleventh leading cause for accessing the telemedicine provider. Five deaths occurred in the study period, three of which related to CVDs. CVDs resulted in more diversions and the utilization of more urgent means of communication.
  
  
  CONCLUSIONS
  CVDs present a challenge in maritime health. The current pre-employment system is not, in a reasonable cost/benefit balance, able to prevent on board events from occurring. The success of telemedicine depends heavily on the onsite resources, both human and material. Automated External Defibrillators (AEDs), along with other devices such as multi-parameter monitors, are tools generally available to address acute presentations of CVDs, but their applicability on board commercial ships is a matter of controversy.
  
  
  CONCLUSIONS
  CVDs are an important concern in commercial maritime operations due to the need for subsequent evaluation and potential complications including the risk of sudden cardiac arrest. In this study, CVDs were probably responsible for three on board deaths. Additional research is warranted to provide more evidence about the best resources to have on board to handle CVDs more effectively.
authors.affiliation: MedAire, Tempe, Arizona, USA. palves3@cox.net
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Alves
authors.forename: Robb
authors.initials: R
authors.lastname: Leigh
authors.forename: Ginger
authors.initials: G
authors.lastname: Bartos
authors.forename: Rita
authors.initials: R
authors.lastname: Mody
authors.forename: Linda
authors.initials: L
authors.lastname: Gholson
authors.forename: Neil
authors.initials: N
authors.lastname: Nerwich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009326:Naval Medicine; D012189:Retrospective Studies; D017216:Telemedicine; D014481:United States / Q000453:epidemiology; D055815:Young Adult