Clinical cardiology consultation at non-cardiology departments: stepchild of patient care?
BACKGROUND
Although patient care in cardiology departments may be of high quality, patients with cardiac disease in other departments tend to receive less attention from cardiologists. Driven by the shorter duration of admission nowadays and the fact that consultations are often performed in between the daily work schedules, the amount of cardiac disease as well as the impact on the daily workload can be underestimated. We determined characteristics, prevalence of cardiac disease and in-hospital mortality of patients in whom cardiology consultation was requested.


METHODS
In this prospective, observational study, individual data of all consecutive patients admitted to non-cardiology departments in whom cardiology consultation was requested were registered.


RESULTS
During the study period, 264 patients were included. Mean age was 70 years. Most patients were admitted to the internal medicine ward (37 %), followed by the surgical ward (30 %). The most common reasons for cardiology consultation were: suspected heart failure (20 %), suspected infective endocarditis (15 %), suspected rhythm abnormalities (14 %) and suspected acute coronary syndrome (13 %). In 29 % of all consultations a cardiac diagnosis was found. Hospital mortality was 9.0 %.


CONCLUSIONS
Patients who are admitted to a non-cardiology department and who need cardiology consultation are particularly elderly people with a high prevalence of cardiac disease and high in-hospital mortality. For these reasons cardiology consultation is an important part of clinical cardiology deserving a structured approach.
Department of Cardiology, Isala Klinieken, Groot Wezenland 20, 8011 JW, Zwolle, the Netherlands.
D A A M
DA
Schellings
T
T
Symersky
J P
JP
Ottervanger
A R
AR
Ramdat Misier
M J
MJ
de Boer