The impact of earthquakes on the frequency and prognosis of the most common emergency cardiac conditions

Abstract

Aim To assess whether the number of patients with a cardiac chief complaint and their characteristics differed between before and after two major earthquakes that struck Croatia in 2020. Methods We collected data on all visits of patients with a cardiac chief complaint examined in the emergency de-partments of six hospitals nearest to the epicenters. Patients seen during the 7 days before the earthquake were compared with those seen on the day and during the 6 days after the earthquake. Results Patients seen after the earthquake were young-er (68 [59-79] vs 72.5 [65-80]; P < 0.001) and less frequently had cardiovascular disease (32.9% vs 42.8%; P < 0.001). This group less frequently had the primary diagnosis of acute myocardial infarction (AMI) (15.6% vs 21.9%; P = 0.005), heart failure (9.3% vs 19.4%; P < 0.001), dysregulated hypertension (13.9% vs 19.4%; P = 0.01), but more frequently had non-anginal chest discomfort (28.8% vs 18.0%; P < 0.001). In a subgroup analysis of patients seen in hospitals lo-cated within 20 km from the epicenter, significantly more patients seen after the earthquake compared with those seen before the earthquake presented with AMI (14.5% vs 22.8%; P = 0.028), acute elevation of blood pressure (10% vs 21.8%, P = 0.001), and paroxysmal arrhythmias treated with electrocardioversion (0.9% vs 4.5%, P = 0.022). Conclusion After two moderately strong earthquakes, hospitals within 20 km from the epicenter saw a signifi-cant increase in acute cardiac conditions such as elevated blood pressure, AMI, and cardioverted arrhythmias. Even-tually, these earthquakes had no impact on the outcomes of the studied population.