ECG often fails to diagnose heart attacks

The majority of heart attacks go undetected

High error rate in heart attack examinations by electrocardiography (ECG): The majority of infarctions are detected too late or not at all To date, two thirds of all heart attacks go undetected on electrocardiograms (ECG), but now  cardiogoniometry” (CGM) offers a new examination method. Whereas ECG does not pick up the signs of an impending heart attack (myocardial infarction), CGM has proven to deliver conclusive findings, explained “Welt Online”. This new examining technique can immediately indicate when a heart attack is threatening to happen and enables early countermeasures to be initiated in time.

Heart attacks are often not detected on an ECG

According to the “Welt Online”, infarction diagnostics based on classic electrocardiography (ECG) is extremely fraught with errors. Around two out of three heart attacks are not detected by ECG at all or not soon enough. The consequence of this is that many patients suffer an infarction unexpectedly – despite previous screenings – and not infrequently, the outcome is fatal. The new diagnostic method called “cardiogoniometry” currently being tested at the Bad Segeberg Cardiovascular Center might offer a remedy to this problem. There, with the help of CGM, a heart attack about to happen was determined in a patient in whom a previous ECG examination produced no signs of the impending heart attack. Immediately after diagnosis, the patient in fact did suffer a myocardial infarction; but in this case, the doctors were prepared and were able to open up occluded vessels without losing any time. The patient survived his heart attack without any complications or late sequelae, “Welt Online” reported.

Improved heart attack diagnosis with CMG

Frequently, patients visit their general practitioner for treatment of nonspecific discomfort in the chest, who usually performs an ECG and possibly an additional lung function test. When patients complain about strong chest pain, feeling of tightness and/or shortness of breath, these are the relative warning signs of a heart attack. However, if the examination
delivers findings within the normal range, the doctors normally see no reason to initiate any further interventions or examinations. But, as reported by “Welt Online”, ECG only detects 30 percent of all heart attacks. That is why doctors have long been searching for an alternative method to diagnose an impending heart attack early. The “cardiogoniometry”
method under testing at the Bad Segeberg Cardiovascular Center was now able to prove its performance capabilities in this regard. Although the ECG was normal, CGM established that the patient was about to have a heart attack which, actually happened several minutes later. This new method will, in the future, enable considerably more accurate
infarction diagnostics, writes “Welt Online”.

High mortality rates from false diagnoses

Nowadays, once a patient has survived a heart attack, their treatment is relatively straightforward. Annually, around 210,000 individuals suffer a myocardial infarction for the first time; as many as 60,000 of them die as a consequence. According to today’s standards, that mortality rate is way too high. According to many cardiologists, the electrocardiogram (ECG), which has been around for over 100 years, is partly responsible for this.

ECG: Not an accurate technique for diagnosing heart attacks

The ECG is by far not as accurate as many patients and doctors would like to believe. Often, the findings of a measurement are completely normal even though a heart attack has taken place. As a result, ECG does not detect two out of every three heart attacks at all or not until it is almost too late. In order to minimize secondary damage and the risk of sudden heart death, every minute counts when a patient is suffering an acute heart attack. If the doctor gives the patient a clean bill of health because their EGK values are otherwise normal and the symptoms are of a rather atypical nature, this might lead to a fatal outcome for the patient; it could cause irreparable damage to the heart muscle or the affected person could die suddenly because life-saving measures were not initiated. Blood tests for the biomarker troponin can detect myocardial infarctions in around 50 percent of patients. However, this proof is usually not obtained until hours after the infarction has already taken place. The blood test identifies certain inflammatory reactions by the body that can point to a heart attack. This method is similarly inaccurate and is mostly only used as an additional measure to confirm or rule out the suspicion or to detect other inflammatory values.

Cardiogoniometry detects precursor states and infarctions

Now, with the relatively new method of cardiogoniometry (CGM), 70 percent of all silent heart attacks and precursors like acute perfusion disturbances in the heart can be demonstrated. That means that this method is around twice as accurate as ECG. Similar to the conventional ECG diagnostic technique, electrodes are attached to the suspected patient. A total of five are placed on the chest and the back. The software measures the signals emanating from the heart muscle an converts them into a three-dimensional graphic image which gives a good picture of any lesions of the myocardial (heart muscle) tissue. By this method, emergency physicians and general practitioners can discover a heart attack faster or also diagnose the warning signs like angina pectoris or perfusion disorders of the heart with reliable certainty. The first findings of a CGM examination are ready within just 12 seconds. When the first study on the new technique was presented at the 2010 European Cardiology Society’s Conference in Stockholm, the results caused a real furor. Now, a new comparative study has shown that the accuracy of the method is two-and-a-half times more accurate than conventional ECG. Another advantage of the new diagnosis technique is its easy handling. The device can also be used in patients with disabilities and physical limitations.

Very good support for general practitioners’ decision-making

Upon completion of the study, one of the researchers reported: “To our great surprise, observations showed a very high correspondence between the fast yet affordable CGM, on the one hand, and highly sophisticated magnetic resonance imaging on the other. This holds great promise for the future of cardiogoniometry.” If that proves true, then every general practitioner would be in the comfortable situation of being able to diagnose impending cardiovascular diseases with good accuracy or, in the case of an acute heart attack, to immediately initiate emergency measures. Moreover, the diagnostic process could be simplified because severe heart diseases could be ruled out quickly and other therapies or examinations continued. Not infrequently, young people in particular who feel tightness in the chest, don’t have a problem with their heart, but with their muscles and their symptoms are actually caused by tension or back pain. Accordingly, applications of the new CGM heart diagnosis technique will primarily benefit general practitioners in structurally weak or rural regions. Heart specialists are expecting that CGM will offer an important decision-making tool for private practice. This will enable general practitioners to make faster decisions as to whether the patient should be admitted to a hospital or whether more advanced outpatient management is sufficient.

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