Short Communication
Characteristics and outcomes of patients with cardiac conditions requiring emergency medical retrieval from the Great Barrier Reef, Australia
AUTHORS
Robert T Harvey1 FRACP, Cardiology Fellow * 
Katrina Starmer2,3,4 FACEM, Consultant Emergency Physician
Theodore Sklavos5 MBBS, Medical Registrar
Tim Cahill6 Grad Cert Child & Family Health, Consultant Emergency Physician
Gregory Starmer1 FRACP, Consultant Cardiologist and Director of Cardiology
John O'Neill2,7 RCSEd, Consultant Emergency Physician
Robert Mitchell8,9 FACEM, Consultant Emergency Physician
AFFILIATIONS
1 Cardiology, Cairns Hospital and Hinterland Health Service, Qld, Australia
2 Emergency, Cairns Hospital and Hinterland Health Service
3 College of Medicine and Dentistry, James Cook University
4 Royal Flying Doctor Service
5 Medicine, Cairns Hospital and Hinterland Health Service
6 Emergency, Mareeba Hospital, Mareeba, Qld, Australia
7 Lifeflight Retrieval Medicine, Cairns Base, Aeroglen, 12 Bushpilots Avenue, Qld 4870, Australia
8 Emergency & Trauma Centre, Alfred Health
9 School of Public Health & Preventive Medicine, Monash University
ACCEPTED: 15 May 2024
early abstract:
Introduction: There is limited published data on the burden of cardiac disease among patients requiring emergency medical evacuation from the Great Barrier Reef (GBR), a popular tourist destination in Far North Queensland, Australia. This aim of this study was to examine the characteristics and outcomes of patients with cardiac conditions who were retrieved from the northern GBR to Cairns Hospital.
Methods: This observational study was a planned sub-study of a broader analysis of medical retrievals from the Cairns/Cooktown section of the GBR. It included all patients retrieved to Cairns Hospital between July 2016 and January 2020 who were assigned a cardiac diagnosis during their hospital stay. Data were collected about electrocardiograph, cardiac troponin blood test and invasive coronary angiography (ICA) results as well as final hospital diagnosis.
Results: During the study period, 120 patients were retrieved from the GBR to Cairns Hospital, of which 46 (38%) were subsequently diagnosed with a primary cardiac condition(s) or other disease process with clinically significant cardiac involvement. The most common diagnoses were type 2 myocardial infarction (20; 16.7% of all retrievals), primary cardiac arrhythmia (14; 12.5%) and acute coronary syndrome (5; 4.2%). An elevated troponin was recorded in 30% of all retrievals and in 78% of those with a cardiac diagnosis. 14 (30.4%) of patients with a cardiac diagnosis died during their hospital admission. ICA was performed in 18 cases, of which 6 had obstructive coronary artery disease. Four patients required percutaneous coronary intervention.
Discussion/Conclusion: A high proportion of patients retrieved to Cairns Hospital from the GBR were diagnosed with a primary cardiac condition. This data may assist tourism operators, retrieval organisations and health services to plan for, and respond to, cardiac events among visitors to the reef.
Keywords: cardiac arrest, cardiology, coronary angiography, (myocardial) infarction, (Great Barrier) Reef, Retrieval, Takotsubo (cardiomyopathy), troponin.