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Acute Cardiac Care 2008

Survival Rate of 5% from Cardiac Arrest Outside Hospital Prompts Congress to Highlight that Immediate Intervention is Key to Survival Rate

Acute Cardiac Care Acute Cardiac Care 2008 drew to a close on 28 October, after delegates spent four days discussing what Dr. Marco Tubaro described as "the most challenging field of cardiology" - acute cardiac care and its sub-specialties.
Acute Coronary Syndromes (ACS)

Cardiac Intervention DemonstrationMany issues were addressed in the Versailles congress centre, and high on the agenda were the challenges facing the Intensive Cardiac Care Units (ICCUs) and the subspecialty of acute care. The ESC Working Group aims to establish the status of the ICCU as the correct place to treat all patients who need acute cardiac care, to develop guidelines for the ICCUs in Europe, and to establish acute cardiac care as a self-contained medical sub-specialty.

Also of importance during the event were discussions on the continuing high rates of mortality among acute infarction subjects. Survival rates when the arrest takes place outside the hospital are no better than 5% in most European countries and much depends on immediate intervention. “Resuscitation should begin within three or four minutes of cardiac arrest,” says Professor Danchin (Hôpital Européen Georges Pompidou, Paris), Vice-Chairman of the ESC Working Group on Acute Cardiac Care. “That’s why it’s so important to teach the basics of resuscitation to the whole population. And that should begin in schools.” America is cited as a good example, where survival rates are slightly better thanks, in part, to public health campaigns and more defibrillators in public places.

Talks were held on the time delay between onset of symptoms and first medical contact. Contact should be made in under one hour, whereas at present it is closer to 4-6. There has been little improvement in this area and it is something that must be addressed in the medical community. The first 60 minutes is often referred to as the ‘Golden Hour’ as the patient suffers virtually no myocardial damage if treated within this time frame. Public education is absolutely vital and a more efficient paramedical service will not suffice. People need to be aware of the symptoms and signs of acute heart failure so as to react to these as quickly as possible.

Last, but not least, delegates looked at the treatment of acute heart failure. As Professor Danchin said: "we need to new ways to manage these patients". The treatment of acute heart failure still lacks efficient medication. There have been improvements, but there is still a high rate of acute and sub-acute mortality in patients. New data on the way patients are managed was presented at the Congress, particularly in accordance (or not) with the latest guidelines. The Congress also reviewed the latest ESC Guidelines on the treatment of AMI and emphasized that early emergency PCI should be the “default strategy.”