Abstract
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.
Learning objective
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.
Keywords
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References
- Smart wearable devices in cardiovascular care: where we are and how to move forward.Nat. Rev. Cardiol. 2021; 18: 581-599https://doi.org/10.1038/s41569-021-00522-7
- First case reported of a Prinzmetal vasospastic angina diagnosed with the help of a smartwatch.EP Eur. 2020; 23: 928https://doi.org/10.1093/europace/euaa372
- Smart watch recording of ventricular tachycardia: case study.Am. J. Emerg. Med. 2020; 38: 849.e3-849.e5https://doi.org/10.1016/j.ajem.2019.10.040
- Smartwatch detection of ventricular tachycardia: case series.Heart Case Rep. 2020; 6: 800-804https://doi.org/10.1016/j.hrcr.2020.08.003
- The clinical significance of continuous ECG (ambulatory ECG or Holter) monitoring of the ST-segment to evaluate ischemia: a review.Prog. Cardiovasc. Dis. 2013; 56: 195-202https://doi.org/10.1016/j.pcad.2013.07.001
- Coronary microvascular spasm causes myocardial ischemia in patients with vasospastic angina.J. Am. Coll. Cardiol. 2002; 39: 847-851https://doi.org/10.1016/S0735-1097(02)01690-X
- Clinical implications of an implantable cardioverter-defibrillator in patients with vasospastic angina and lethal ventricular arrhythmia.J. Am. Coll. Cardiol. 2012; 60: 908-913https://doi.org/10.1016/j.jacc.2012.03.070
- Beta blockers versus calcium channel blockers for provocation of vasospastic angina after drug-eluting stent implantation: a multicentre prospective randomised trial.Open Heart. 2020; 7e001406https://doi.org/10.1136/openhrt-2020-001406
- 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC.Eur. Heart J. 2021; 42: 373-498https://doi.org/10.1093/eurheartj/ehaa612
- 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: the Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC).Eur. Heart J. 2020; 41: 407-477https://doi.org/10.1093/eurheartj/ehz425
Article info
Publication history
Published online: May 19, 2022
Accepted:
April 17,
2022
Received in revised form:
March 22,
2022
Received:
February 7,
2022
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
