fatal heart attack
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Findings presented at the American Heart Association’s 2018 Scientific Session in Chicago, USA, show how a smartphone app can rapidly detect a fatal heart attack.

Heart disease is the leading cause of death around the world. The term refers to a number of conditions that occur when the heart muscle is damaged or does not function properly. This can cause plaque to accumulate in the heart’s arteries, increasing the risk of heart attack, stroke, or heart failure. A large number of heart disease deaths are due to heart attack and stroke.

ST-elevation myocardial infarctions (STEMIs) are a type of heart attack and are the second leading cause of death in Canada after cancer. They involve the complete blockage of a coronary artery, a type of artery supplying blood to the heart. This blockage damages the entire thickness of the heart muscle, resulting in visible changes that can be detected on an electrocardiogram (ECG). The symptoms can be severe and life-threatening.

Identifying and treating STEMIs are critical to preventing deaths

Detecting STEMIs with an ECG result in proper diagnosis and treatment. Rapidly identifying and treating STEMIs are critical to preventing a fatal heart attack. A recent international study, led by researchers from the Intermountain Medical Heart Institute in Salt Lake City, Utah, USA, found that a smartphone app can be used to monitor heart activity and detect STEMIs.

The study involved 204 patients experiencing chest pain. Each patient received both a 12-lead ECG (a standard ECG used to detect heart attacks) and an ECG using the AliveCor smartphone app. A 12-lead ECG uses 10 electrodes positioned around the body to measure 12 different views of heart activity. The AliveCor app uses a two-lead system, and wire leads are moved around the body to record all 12 angles of heart activity.

App detects STEMIs with accuracy comparable to an ECG

The results, presented at the American Heart Association’s 2018 Scientific Session in Chicago, show that the app is able to detect STEMIs with high accuracy compared to a 12-lead ECG. In addition, the app did not falsely indicate a heart attack if the patient was not experiencing one.

STEMI heart attacks are treated with a percutaneous coronary intervention (PCI), a procedure that reopens coronary arteries using a balloon or catheter. This treatment restores blood flow to the heart, and stents are placed in the blocked arteries to maintain blood flow. Studies have shown a strong relationship between door-to-balloon time, which is the time from when a patient enters the hospital to when they receive a PCI, and risk of in-hospital death. According to the American Heart Association, the door-to-balloon time for STEMI patients should be less than 90 minutes to limit the number of fatal heart attacks.

New app can speed up treatment process

This new app can speed up the treatment process for patients by quickly identifying STEMIs. Some patients with chest pain might not seek out treatment if they feel that symptoms are minor, delaying the time taken to receive treatment. With the app, ECG data is sent directly to a cardiologist, who can confirm the occurrence of a STEMI and urge patients to be treated immediately.

The app also provides a low-cost alternative to ECG testing, making treatment and diagnosis more accessible to people in developing countries with limited healthcare resources. This study provides important insight into how technology can be used to address global healthcare problems and limit deaths from major disease.

Written by Braydon Black, BSc

References:

  1. Public Health Agency of Canada. Report from the Canadian Chronic Disease Surveillance System: heart disease in Canada, 2018 [Internet]. Ottawa: Public Health Agency of Canada; May 2018 [cited 2018 Nov 17]. 63 p. Pub. No.:170307. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/report-heart-disease-Canada-2018.html#s1-2
  2. Nippak P, Pritchard J, Horodyski R, Ikeda-Douglas CJ, Isaac WW. Evaluation of a regional ST-elevation myocardial infarction primary percutaneous coronary intervention program at the Rogue Valley Health System. BMC Health Serv Res [Internet]. 2014 Oct [cited 2018 Nov 17];14:449. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263118/ doi: 10.1186/1472-6963-14-449
  3. Heart and Stroke Foundation of Canada. Heart attack [Internet]. Ottawa: Heart and Stroke Foundation of Canada [unknown date] [cited 2018 Nov 17]. Available from: https://www.heartandstroke.ca/heart/conditions/heart-attack
  4. Intermountain Healthcare. Study finds phone app effectively identifies potentially fatal heart attacks with the near accuracy of a standard ECG [Internet]. Utah: Intermountain Healthcare 2018 Nov 11 [cited 2018 Nov 17]. Available from: https://intermountainhealthcare.org/news/2018/11/phone-app-identifies-potentially-fatal-heart-attacks/
  5. CorHealth Ontario. ST elevation myocardial infarction (STEMI) [Internet]. Toronto: CorHealth Ontario [unknown date] [cited 2018 Nov 17]. Available from: https://www.corhealthontario.ca/resources-for-healthcare-planners-&-providers/stemi/stemi-resources
  6. Swaminathan RV, Wang TY, Kaltenbach LA, Kim LK, Minutello RM, Bergman G, Wong SC, Feldman DN. Non-system reasons for delay in door-to-balloon time and in-hospital mortality: a report from the National Cardiovascular Data Registry. J Am Coll Cardiol [Internet]. 2013 Apr [cited 2018 Nov 17];61(16):1688-95. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23500264 doi: 10.1016/j.jacc.2012.11.073
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