Often no heart attack diagnosis using an EKG


High error rate in cardiac infarct examinations using electrocardiograms (EKG): majority of infarcts are detected too late or not at all

So far, two thirds of all heart attacks are not recognized on an electrocardiogram (EKG), but now "cardiogoniometry" (CGM) offers a new examination method. While the ECG showed no signs of an impending heart attack (myocardial infarction), the CGM delivered clear results, explained "Welt Online". With this new examination technique, an impending heart attack is indicated immediately and appropriate countermeasures can be initiated at an early stage.

Heart attacks are often not recognized in the EKG According to "Welt Online", heart attack diagnosis based on the classic electrocardiogram (EKG) is extremely error-prone. Around two out of three heart attacks would not be recognized or not recognized in time by the EKG. As a result, many patients - despite previous examinations - suffer from an infarct that is unprepared and often ends in death. This could be remedied by the new diagnostic method of "cardiogoniometry", which is currently being tested at the Bad Segeberg Heart Center. Here, with the help of the CGM, an impending heart attack was found in a patient who showed no signs of an impending heart attack during the previous ECG examination. Immediately after the diagnosis, the patient actually suffered a myocardial infarction, but since the doctors were prepared, the closed vessels could be opened without wasting time and the affected person survived the heart attack without further complications and late effects, reports "Welt Online".

Improved diagnosis of heart attacks by CMG Patients with non-specific chest pain often go to their family doctor for treatment, whereupon the doctor usually carries out an EKG and possibly a lung function test. If patients complain of severe chest pain, tightness and shortness of breath, these are relatively often signs of a heart attack. However, if the examination results remain within the scope, there is normally no reason for the doctors to initiate further measures or examinations. But with the help of the EKG, only 30 percent of heart attacks are recognized, reports “Welt Online”. For this reason, doctors have been looking for an alternative method to diagnose an impending heart attack at an early stage. The “cardiogoniometry” method tested in the Bad Segeberg Heart Center has now put its performance to the test. Although the ECG was normal, the CGM was able to identify an impending heart attack in one patient, which actually occurred a few minutes later. "Welt Online" writes that the new procedure could enable a much more precise diagnosis of the heart attack in the future.

High death rate due to incorrect diagnoses
If the patient has survived a heart attack, it can be treated relatively well today. Every year around 210,000 people suffer a heart attack for the first time, of which 60,000 still die from the consequences. By today's standards, the death rate is far too high. In the opinion of many cardiologists, the approximately 100-year-old electrocardiogram (EKG) bears joint responsibility.

EKG: No exact diagnostic technique for heart attacks
The EKG is nowhere near as accurate as many patients and doctors believe. The results of a measurement are often completely normal, even though a heart attack has occurred. As a result, two out of three heart attacks cannot be recognized at all or only very late by the ECG. If there is an acute heart attack, every minute counts to minimize consequential damage and the risk of sudden cardiac death. If the doctor gives an all-clear signal that the patient shows otherwise unremarkable EGK values ​​and the symptoms are rather atypical, this can have fatal consequences for the patient. Irreparable damage to the heart muscle can occur and the person affected can suddenly die because life-saving measures have not been initiated.

A blood test of the biomarkers (troponin) can be used to detect a myocardial infarction in around 50 percent of the cases. However, this proof is usually only possible hours after the infarction has already taken place. The blood test shows certain inflammatory reactions in the body that can indicate a heart attack. This method is also imprecise and usually only serves as an additional measure to include or exclude a suspicion or to discover another inflammation value.

Cardiogoniometry recognizes heralds and infarcts
With the relatively new method CGM (cardiogoniometry), 70 percent of all hidden heart attacks and preliminary stages such as acute circulatory disorders in the heart can now be detected. The method is about twice as accurate as the EKG in comparison. Similar to conventional EKG diagnostic technology, electrodes are placed on the skin of the suspected patient. A total of five pieces are placed on the chest and on the back. Using measured heart muscle signals, the software can show a three-dimensional graphic representation on which changes in the heart muscle tissue can be easily read. Emergency physicians or general practitioners can identify a heart attack more quickly or can almost certainly diagnose heralds such as angina pectoris or cardiac circulatory disorders. A first result of the examination is announced after a good twelve seconds. When the first study on the new technology was presented at the European Cardiologists' Congress in Stockholm in 2010, the results caused a sensation. Now, a new comparative study shows that the significance of the procedure is two and a half times more accurate than that of a conventional ECG. Another advantage of the new diagnostic technology is the easy handling. The device can also be used in patients with disabilities or physical limitations.

Used primarily for general practitioners to support decision-making
After completing the study, one of the researchers reported: "To our great surprise, observations have also shown a very high correspondence between the fast-to-use and inexpensive CGM on the one hand and the highly complex magnetic resonance tomograph on the other. That suggests a great deal for the future of cardiogoniometry. ”This would make it easy for any family doctor to diagnose imminent cardiovascular disease almost accurately or to take immediate emergency measures in the event of an acute heart attack. In addition, the diagnostic procedure could be simplified because serious heart diseases can be ruled out quickly and further therapy or examinations can be continued. Because often in young people in particular, stinging in the chest does not come from the heart, but from the muscles, for example, and is actually tension or back pain.

The new CGM cardiac diagnosis technology should therefore be used primarily by general practitioners in structurally weak or rural areas. Cardiac specialists expect that the devices will be an important decision-making aid for doctors in the field. This allows the family doctor to decide more quickly whether the patient should be admitted to a clinic or whether further outpatient therapy is sufficient. (fp, sb)

Read on:
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Workplace stress increases the risk of heart attack

Image: Michael Bührke / pixelio.de

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