Telemedicine: utility for care and monitoring in ischemic cardiac disease

Telephone linked care technology has been developed and applied as a supplement for ambulatory visits, as a means to offer a specific cardiac diagnosis during a general family doctors´ visit. The method was as follows: from February to July 1998, 178 family doctors had a mobile electrocardiogram (Card Guard 7100) which was able to transmit via any fixed or mobile telephone to a center where a cardiologist was present for the analysis of the ECG and for an interactive opinion. During the first six months 2254 patients were enrolled (mean age 63±8 years), 609 patients (27%) had systemic hypertension, 283 patients (12%) had ischemic cardiac disease and 850 (37%) had no evidence of previous cardiopathy. In this paper the results of the subgroup with known coronary artery disease were analysed. In this subgroup 157 patients (55%) were asymptomatic at the moment of ECG recording, while 126 patients (45%) referred chest pain in 54 (43%), dyspnoea in 34 (27%), dizziness in 15 (12%), asthenia in 15 (12%) and palpitation in 10 (8%). No actions were taken in 179 (63%) of the patients; 22 patients (8%) were addressed to the emergency department in 25 patients (9%) were suggested further investigations and in 57 patients (20%) a new therapy or a therapeutic change was suggested. In conclusion, telemedicine is an useful tool to support family doctors in the diagnosis of the cardiac disease