Glöckner David, Zeus Tobias, Kelm Malte, Makimoto Hisaki
Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
J Cardiol Cases. 2022 May 20;26(3):169-172. doi: 10.1016/j.jccase.2022.04.006. eCollection 2022 Sep.
A 44-year-old male patient presented to our clinic with nocturnal palpitations. The smartwatch electrocardiogram (ECG) demonstrated ST-segment deviation and non-sustained ventricular tachycardias. The patient suffered from coronary one-vessel disease. The coronary angiography revealed de novo proximal left anterior descending stenosis and in-stent restenosis, which necessitated coronary stenting. However, the recurrent palpitations reappeared 2 weeks later. The smartwatch ECGs again demonstrated ST-segment deviation and wide QRS tachycardia, reassessments with coronary angiography and magnetic resonance imaging revealed no relevant ischemia. The patient was diagnosed with vasospastic angina. His symptoms disappeared after percutaneous administration of nitrates.This case highlights the utility of smartwatch ECGs to support clinical diagnosis, decisions, and follow-up in the case of ischemic attacks.
This case report highlights the importance of an adequate anamnesis and the meaningful use of wearable devices. The smartwatch enables the patient to record electrocardiograms (ECGs) easily and immediately during symptoms. That is one of the major advantages of this new technology, because we can even detect events that are too subtle to be detected in the normal 24-h Holter ECG. This case highlights the utility of smartwatch ECGs to support clinical diagnosis and decisions by establishing a valid symptom-ECG correlation.
一名44岁男性患者因夜间心悸前来我院就诊。智能手表心电图显示ST段偏移和非持续性室性心动过速。该患者患有冠状动脉单支病变。冠状动脉造影显示左前降支近端新发狭窄及支架内再狭窄，需要进行冠状动脉支架置入术。然而，2周后再次出现心悸。智能手表心电图再次显示ST段偏移和宽QRS心动过速，冠状动脉造影和磁共振成像复查未发现相关缺血。该患者被诊断为变异性心绞痛。经皮给予硝酸酯类药物后症状消失。本病例突出了智能手表心电图在缺血性发作时支持临床诊断、决策及随访的作用。
本病例报告强调了充分问诊及合理使用可穿戴设备的重要性。智能手表使患者能够在症状发作时轻松、即时地记录心电图。这是这项新技术的主要优势之一，因为我们甚至能够检测到在常规24小时动态心电图中难以察觉的细微事件。本病例通过建立有效的症状 - 心电图关联，突出了智能手表心电图在支持临床诊断和决策方面的作用。
