Case Study 1

Patient 79 Years Female Normal

Case study 1 shows a patient:

  • Female
  • 79 years of age
  • Minor symptomatic condition

 

The first ECG, conducted in hospital, was normal. Blood analysis showed no abnormal results.

The second ECG, the following day, at the general practitioner’s surgery came also back normal, contrary to the Cardiogoniometry findings, which showed a pathological CGM – suspicion of myocardial ischemia or CAD. A referral to the cardiac catheter lab to exclude a CAD was prescribed.

Below all examination results are listed.

  • ECG
  • Blood values
  • Echo
  • Coronary angiography
  • Cardiogoniometry data
Diagnosis after 2 stentings with 5 stents overall
  1. 3-G CHD with very good result after PCI of marginalis, the RCX and RCA each with DES
  2. PCI currently with T-stenting of the LAD at the DI, each with Resolute Integrity DES 2:25 in DI and-8mm-18mm 2.75 in LAD with a very good result
  3. Condition following coro with unstable AP and severe coronary artery disease with 3G at the time
    • 70% distal RCA stenosis
    • Subtotal stenosis MI
    • 90% stenosis RCX
    • 70% LAD stenosis
    • PCI with DES in MI Resolute Integrity 2:25-14mm
    • PCI with DES in RCX Resolute Integrity 3.014mm
    • PCI with DES in the RCA Resolute Integrity 2.75-14mm
  4. Moderate diffuse sclerosis
  5. After echocardiographic criteria then regular RV and LV function
    • Discrete aortic sclerosis, severe mitral valve sclerosis
    • Mild tricuspid and mitral valve insufficiency
Electrocardiogram (12C Rest-ECG)
EKG 1
Cardiogoniometry (CGM)
CGM Writer
Potential view
3D Loops with a clear pathologic sign
Zoom of the 3D Loop of the T-Wave
Max-vector view with signs of acute ischemia and an instable situation
Automatic interpretation indicates abnormal CGM

Cardiogoniometry (CGM) before 1. Coronary Angiography

The automatic interpretation of CGM for a normal set of parameters shows a result of -2, which means that one of the combined parameters is pathological. The reason is the potentials measured, which are predominantly located at the basal part of the heart. This means only a few potentials were measured on the opposite side, the apex.

The assertion is confirmed by the imaging of the low R wave in the potentials as well as the maximum vectors imaging.

This can be seen in combination with the CGM writer, as the “S” here runs fairly low. The conclusion cannot be made solely from the potential analysis. It provides only an indication in this instance.

The broad distribution in “T” (green) indicates perfusion deficits of the myocardium.

Interpreting the three-dimensional display of the propagation conduction, a strong deviation of the R maximum vector from the y-axis, which represents the anatomical axis through the apex of the heart. Meaning that the sum vector of the excitation does not advance in the direction of the cardiac apex, which would be the case with a healthy volunteer.

In addition, the non-homogeneous loop structure suggests a pathological condition.

CGM recognizes the reading as pathological due to a certain percentage of the R waves (QRS) progressing into the basal region.

In connection with the scattering of the T maximum vector, which the physician can see in the globe view, this indicates an acute condition.

Echography
Echo 1
Echo 2
Echo 3
Echo 4
Echo 5
Echo 6
Echo 7
Echo 8
 1. Coronary Angiography

1. coronary angiography

12C Rest-ECG after Coronary Angiography
EKG 2
12C Rest-ECG before 2. Coronary Angiography
EKG 1
2. Coronary Angiography
12C Rest-ECG after 2. Coronary Angiography
EKG 1
Cardiogoniometry (CGM) after Coronary Angiography
CGM Signal X,Y and Z axis
Potential view
3D Loop shows good signs
t-wave also clear and good condition

The bend in the loop could be an indication of a past anomaly. However, this cannot be conclusively established. In contrast to the initial examination, the shape of the loop has converged to the standard form and is no longer classified as pathological. The score is now “0”, which means it is not pathological.

the max vector view indicates that al vectors are in the same direction