At risk for cardiac emergency? Include medical records and ECG results with your cruise luggage.

The phrase “at sea” takes on a whole new meaning when a cruise ship passenger experiences a coronary emergency. Cruise ships’ doctors rarely have access to a patient’s medical records, information that could guide decisions in a situation where access to diagnostic cardiology equipment, or emergency therapies, may be limited.

A study published in the Jan. 15 issue of the the American Journal of Cardiology reveals that coronary emergencies are not uncommon on vacation cruises.

The authors recommend that passengers with a history of heart problems, or who are at risk for cardiovascular events, have a pre-cruise medical evaluation. If a 12-lead electrocardiogram (ECG) reveals any abnormality, the traveler should bring a copy of it along on the trip.

Dr. Gian Novaro of the (Cleveland Clinic Florida in Weston) and his colleagues based their conclusions on a study of 100 cardiology consultations for patients on ships operated by five major cruise lines. Average age of the patients in the study was 66. Three percent of the patients died on board ship. Seventy-three percent of the patients were subsequently hospitalized, and 4 percent of the hospitalized patients died.

The most common symptoms reported to shipboard physicians were: chest pain (50%) followed by dyspnea (19%), palpitations (13%), syncope/near syncope (10%), and “other,” which included vague symptoms such as nausea, rashes and weakness (10%).

The American College of Emergency Physicians (ACEP) recommendations for cruise ships, “Healthcare Guidelines for Cruise Ship Medical Facilities” suggest that, depending on a ship’s size, diagnostic and emergency medical equipment on board include an electrocardiograph.

According to Dr. Novaro and his colleagues, most large cruise lines follow the ACEP guidelines, but many smaller companies do not.

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