Suspected acute coronary syndrome in a theater of operations: first management, medical evacuation, and final diagnosis: experience of the French Medical Army

Mil Med. 2009 Jun;174(6):605-9. doi: 10.7205/milmed-d-02-3608.

Abstract

Objective: to evaluate the treatment of the acute coronary syndrome (ACS) among soldiers stationed on a theater of operations by structures usually conceived to treat combat-related trauma.

Methods: We performed a retrospective study involving the whole medical evacuations out of a theater of operations to the benefit of the French Armed forces, for a suspected diagnosis of ACS.

Results: 35 patients were included in this study with 20 for a diagnosis of persistent ST-Segment Elevation Myocardial Infarction (STEMI). Only an active smoking defined a population at risk in these high medical selective soldiers. The agreement between the initial and the final diagnosis was excellent for STEMI but remains perfectible for NSTEMI.

Conclusion: the medical structures deployed in a theater of operations were able to provide first treatment in ACS. The use of powerful diagnosis test, like troponine assay, must allow a better selection of the patients justifying a medical evacuation.

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / epidemiology
  • Acute Coronary Syndrome / therapy
  • Adult
  • Body Mass Index
  • Emergencies
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Military Personnel*
  • Patient Selection
  • Patient Transfer* / organization & administration
  • Retrospective Studies
  • Risk Factors
  • Troponin / blood
  • Warfare*

Substances

  • Troponin