Improving early identification of cardiovascular problems at the point-of-care

Background

Patient 00 has an artificial valve or prosthesis. The patient is under cardiology observation. However, the next cardiology appointment is 6 months out. The patient had mild chest discomfort and was worried as the prosthesis was relatively new.

For the record, neither the ECG nor the CHART detected the prosthesis.

ECG use Case

GP consulted the patient file and found there was a prosthesis. An ECG was done, where it showed PAC and prolonged PR but was otherwise inconclusive. Auscultation by GP indicated a possible murmur, but could not identify any sounds that could be attributable to the prosthesis. There were no sounds typical of a malfunctioning prosthesis. Based on this, no referral to cardiology was made.

CHART use Case

After confirming the presence of the prosthesis from the patient's file, the GP reviewed the CHART report that showed the presence of a Diastolic Murmur, but otherwise, there were no noises or vibrations or high frequency or high and narrow amplitudes consistent with a malfunctioning valve. S1 and S2 appeared normal. GP concluded the prosthesis seemed to be working properly.

Of greater concern, the CHART Report showed HART-Findings of an Abnormal LVH, mild Wall Motion Abnormality, Impaired relaxation, and an LVEF of 61%. The ECG part showed PAC and a prolonged PR. The MCG part showed an Abnormal PEP (Pre-Ejection Period) and SPI (Systolic performance indices, related to cardiac time intervals).

Separately, the indications could be attributed to the prosthesis. Taken together, however, the CHART report was painting a picture of a heart being stressed, likely by the prosthesis. Of particular concern was the Abnormal LVH. The GP referred the patient back to the cardiologist on an immediate priority (within 14 days)

Conclusion

The CHART report provided key information that was not available using ECG alone. CHART helped the GP determine the patient's correct cardiac status which helped determine the best possible treatment pathway and outcome.

OpenHeart: Novel tech throws knock-out punch to ECG improving GP referral decisions to cardiology