Article révisé par les pairs
Résumé : Objective: To identify main presenting complaints of heart transplant patients in the emergency unit (EU) and their diagnostic and therapeutic particularities Design: Retrospective review of the medical records of all heart transplant patients who presented at the EU of the Erasme Hospital, Brussels, Belgium between 1992 and 1995. Principle measures and results: Forty-eight patients presented to the EU at least once, generating 98 visits and resulting in 70 hospitalisations. Median elapsed time between graft and visit at the EU was 44 months, 14% presenting within the first year. Mortality was seen in 10% of the visits, due to an infectious disease in 50% of cases. The main complaint was fever (19%), difficulty in breathing (14%), trauma (13%) or abdominal pain (11%). The most frequent diagnosis was pneumonia (9%), heart failure (9%), minor trauma (7%), rejection (5%) or peptic ulceration (5%). Complaint and diagnosis were different depending on if the patient presented within the first year after transplant or later. Conclusion: Heart transplant patients who present at the EU have numerous complaints and diagnoses, related to the graft or immunosuppression in half of the cases. Mortality is related to infections, requiring aggressive diagnostic procedures and rapid implementation of therapy. Rejection is rarely diagnosed in the EU.