A Spanish doctor diagnoses a heart attack in an emergency with an Apple Watch

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It happened in Navalacruz, a town in the Sierra de Gredos, during the patron saint festivities

Dr Santos.
Dr Santos.MS

navalacruz It is a small town at the foot of the Sierra de Gredos which, like many other towns in Spain, multiplies its population during the summer. It has 247 registered inhabitants but last September in its streets there were thousands of people celebrating the patron saint festivities. This saved a person’s life.

one of them was Blanca Santos Martin, cardiology in his first year of residency at the La Princesa hospital in Madrid. Blanca had come to town to spend a few days with friends and family and one night she received a call on her phone. The aunt of a friend of hers was not feeling well at home and she had a pain in her chest. Upon arrival, Blanca verified that it was a pain compatible with acute coronary syndromewhich is traditionally known as a heart attack.

When there is a medical emergency in Navalacruz, its inhabitants have two possibilities. One is to call an ambulance in the area, which usually takes about 20 minutes to arrive. The other is to request a mobile UVI in Avila, which takes almost an hour.

The local ambulance is equipped with a electrocardiograph, which is the device that measures the electrical activity of the heart and allows an accurate diagnosis to be made. But, upon arriving at the patient’s house, Dr. Santos discovered that the device did not work. During his medical studies, he had attended several talks by Dr. Miguel Ángel Cobos Gil, a cardiologist at Hospital Clínico San Carlos, in which he discussed the possibility of using the Apple Watch as a diagnostic device, and he decided to try it as an alternative.

“My Apple Watch is not one of the latest models, so it does not have an electrocardiograph, but a relative of mine who was also in town those days did have a model equipped with one,” Dr. Santos explains to EL MUNDO.

Apple clearly explains when opening the EKG app on the Apple Watch that the function is not prepared to detect heart attacks. It is a tool designed to take frequent measurements at home that can help a doctor to obtain a more complete vision of the patient’s health. It can also detect cases of atrial fibrillation, which is a type of arrhythmia that can be indicative of other heart problems.

Other smartwatch manufacturers, such as Samsung, have also integrated these types of tools into their devices, but the limitations and caveats are the same. This is mainly due to the fact that the device takes a measurement from a single point on the body, the wrist, and to obtain an accurate diagnosis it is necessary to see the electrocardiogram that is also drawn from other points of the body.

This is what Dr. Santos did. “I took three leads with the watch on different parts of the body (from the left wrist to the right wrist, which is the usual Apple Watch, and from the left ankle to the right and left hand) and the graph clearly pointed to a heart attackthe lower face of the heart was being compromised,” he explains.

A heart attack is a pathology with a high degree of mortality if it is not detected and treated on time; in fact, it is estimated that around 25% of patients die before reaching the hospital. From the time it is diagnosed, the ideal is to open the responsible artery percutaneously (that is, from the outside, piercing the skin) within two hours. If not, you can only resort to less effective alternatives such as the use of an intravenous medication.

With the information from the electrocardiogram, Dr. Santos asked the ambulance to take the patient to the Salamanca hospital, located a little further than the one in Avila, but where there is the possibility of opening the artery emergently. A few days later the patient had recovered and could come home.

Santos believes that in the near future this type of device will be able to improve the direct diagnosis of heart attacks. “With the data of millions of patients, it will be possible to train more precise algorithms capable of approaching the diagnosis from a single point,” he explains. Now, however, It is only a useful device in cases like this if you know how to interpret the electrocardiogram tracingsomething that requires medical knowledge.

In his residence at the La Princesa hospital, however, he has observed how more and more patients go to the emergency room because the clock has diagnosed atrial fibrillation. One of the fears that existed among the medical community when this feature was announced is that a wave of false positives It would saturate the consultations, but according to Santos, this scenario is not happening at the moment and the function has helped to detect problems in time that would otherwise have posed a serious threat to the health of patients.

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