Apple Watch detects coronary ischaemia

Source: Eur Heart J, ehaa290,

An article in the European Heart Journal describes a case where an Apple Watch was used to diagnose coronary ischaemia during an episode of chest pain.

The authors (Michael Drexler, Christian Elsner, Valentin Gabelmann, Tommaso Gori, Thomas Münzel) describe the case of an 80-year-old woman who presented to the chest pain unit (CPU) at the University of Mainz with the typical angina symptoms of the Canadian Cardiovascular Society Class III.

She also complained of two episodes of pre-examination and did not report any vegetative symptoms. The patient’s medical history included a diagnosis of hypertension, paroxysmal atrial fibrillation and an episode of pulmonary embolism 2 years earlier. Her therapy included aspirin, telmisartan, nebivolol, atorvastatin, and organic nitrate pentaerythritol tetranitrate (PETN).

The patient underwent a 12-channel ECG that revealed no evidence of ischaemia. The high-sensitivity troponin test was also negative. The patient also complained of previous and frequent episodes of ectopic beats that were recorded by her Apple Watch. The smartwatch recordings also included traces of marked ST segment depression.

Based on this evidence of ischaemia, no further diagnosis was made, and the patient was transferred to the catheterization lab, where a left main stem stenosis and a left anterior descending/diagonal lesion of the bifurcation were found. The patient was consequently treated with coronary stenosis and left the hospital the next day.

The authors emphasize that with the ability to perform an ECG and record a 30-second trace, Apple Watch can be used not only to detect atrial fibrillation or atrioventricular conduction disorders, but also to detect myocardial ischaemia.

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