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The apexcardiogram in ischemic heart disease

H H Wayne

    California Medicine
    |January 1, 1972
    PubMed

    Insights

    The apexcardiogram (acg) detects left ventricular dysfunction in heart attack and angina patients. This tool shows earlier changes than ECGs, aiding heart disease diagnosis and monitoring.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Background:

    • The apexcardiogram (acg) is a non-invasive technique to assess cardiac mechanical function.
    • Left ventricular (LV) contractile abnormalities are key indicators in various ischemic heart diseases.

    Purpose of the Study:

    • To evaluate the apexcardiogram's (acg) utility in reflecting left ventricular (LV) contractile patterns in patients with acute myocardial infarction (AMI), preinfarction angina (PIA), and stable ischemic heart disease (IHD).
    • To compare the sensitivity and timing of acg changes versus electrocardiogram (ECG) changes in diagnosing and monitoring these conditions.

    Main Methods:

    • Serial recording of apexcardiograms (acg) in patients diagnosed with AMI, PIA, and IHD.
    • Correlation of acg findings (e.g., systolic wave dyskinesis, 'a' wave amplitude) with clinical presentation and ECG changes.
    • Monitoring acg changes over time and post-intervention (nitroglycerine, coronary bypass surgery).

    Main Results:

    • Abnormal acg patterns, including paradoxical systolic bulging and increased 'a' wave amplitude, were observed in patients with AMI and PIA, often preceding ECG changes.
    • Acg abnormalities during angina pain resolved promptly with nitroglycerine.
    • Patients with stable IHD showed persistent acg patterns, while those undergoing coronary bypass surgery exhibited immediate postoperative improvement.
    • Acg changes were more sensitive and appeared earlier than ECG changes in detecting cardiac dysfunction.

    Conclusions:

    • The apexcardiogram (acg) effectively reflects left ventricular (LV) contractile patterns, potentially serving as an indirect ventriculogram.
    • The acg's enhanced sensitivity and earlier detection of abnormalities make it a valuable diagnostic and monitoring tool for patients with ischemic heart disease.

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