Hearts at Risk – New Infarction Diagnostics Saves Lives

Every 1.8 minutes, somebody in Germany suffers a heart attack – approximately one in three ends fatally. A deficiency in myocardial perfusion, for example caused by an occluded vessel, can irreparably destroy myocardial tissue.

The earliest possible detection of a heart attack is vital to successful management of the persons affected and to increasing their chances of survival. Yet, conventional examination methods such as ECG deliver insufficient accuracy rates at best. These methods only detect 30 percent of all myocardial infarctions. The opposite is true of a new method called cardiogoniometry, which is capable of discovering over 70 percent of all heart attacks without any doubts. The Schwarzwald Medical Resort Obertal, situated in the mountain city of Baiersbronn, is the first private clinic in Germany to start using cardiogoniometry for cardiac examinations.

Atypical and silent heart attacks are most insidious. Whereas your typical heart attack is accompanied by symptoms like pain in the chest, shortness of breath or mortal anxiety that are clear and early signs heralding the pathological event, such signs are absent when an atypical heart attack happens. The silent kind of infarction is expressed by symptoms like fatigue or exhaustion, which however are not associated with a heart attack. In a silent heart attack, even these signals are lacking – it happens without the sufferer even noticing. Yet the effects on the myocardium are at least as life threatening as in a typical heart attack with its familiar concomitant symptoms.

“What makes an atypical or silent heart attack particularly dangerous is that the sufferer does not go to the doctor,” explained Dr. Kai Ruffmann, managing cardiologist at the Black Forest Medical Resort Obertal, a leading private clinic for internal medicine, orthopaedics and naturopathy. “Nevertheless, the risk of suffering another heart attack within the next twelve months and dying of it is very high.” The probability that the second heart attack will also take an atypical or silent course and that life-saving medical help comes too late is that much greater because the affected person again does not recognize the danger, simply because the symptoms are lacking.

In fact, atypical or silent heart attacks are no rarity. According to various studies, it can be assumed that one in four heart attacks takes a silent course. Groups that are most affected include seniors and diabetics. In elderly persons, due to age-related changes, the sensitivity of their cardiac nerves is diminished; in diabetics, this is caused by polyneuropathy, a functional disorder of the nervous system resulting from an imbalance in glucose metabolism. In both populations, the neural damage prevents

the person affected from feeling the typical infarction pain. That is also the reason why an atypical or silent heart attack ends fatally three times more frequently than a typical heart attack does, according to a study published in the medical journal Chest (2004; 126; 461-469).

“High-risk patients like the elderly or diabetics are therefore advised to have a prophylactic exercise ECG done once a year,” says Dr. Ruffmann. However, many people avoid this examination because they have to push themselves to the limit and are therefore afraid of triggering a heart attack by performing the test. This problem is obviated by the new method of cardiogoniometry (CGM), as used at the Black Forest Medical Resort Obertal. CGM delivers much more accurate results compared to conventional exercise ECG and without physical exertion being required. The examination is performed with the patient lying comfortably. Instead of the twelve electrodes that conventional ECG needs, cardiogoniometry only requires five attached to the chest. These leads generate an exact three-dimensional image of the heart on the monitor; additionally, the computer calculates the numerous parameters measured that allow the doctor to evaluate the health status of the patient’s heart. These data is available in just 12 seconds versus the long eight minutes required by conventional ECG.

“Based on these measured results, the doctor can accurately establish whether myocardial perfusion is deficient and hence, whether the patient has a markedly elevated risk of suffering a myocardial infarction,” Dr. Ruffmann explained. “The method also lets us discover whether an earlier primary myocardial infarction has gone undetected. In both instances, action should be taken without delay in order to reduce the heart attack risk or to prevent a second, often fatal heart attack.”

Prophylactic cardiogoniometry is recommended in men over the age of 40 and in women over 50 years of age and is even more important for persons with added risk factors such as obesity, high blood pressure, fat metabolism disorders, stress or a familial predisposition to frequent heart attacks. Additionally, any person suffering unclarified symptoms in the chest where previous ECG examinations produced negative findings should consider getting tested by cardiogoniometry. The same applies to sufferers who in the past have experienced sudden attacks of nausea, fatigue or exhaustion for no recognizable reason. One explanation for these

conditions might be an atypical or silent heart attack which can likewise be followed by a second and potentially fatal myocardial infarction. A brief, 8-second cardiogoniometric examination can help avert this fate and extend the warranty for a long life.

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Schwarzwald Medical Resort Obertal


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