The electrocardiogram on the wrist: a frightening experience to the untrained consumer: a case report

BACKGROUND: Smartwatches offering electrocardiogram recordings advertise the benefits of supporting an active and healthy lifestyle. More often, medical professionals are faced with privately acquired electrocardiogram data of undetermined quality recorded by smartwatches. This is boasted by results and suggestions for medical benefits, based on industry-sponsored trials and potentially biased case reports. Yet potential risks and adverse effects have been widely overlooked. CASE PRESENTATION: This case report describes an emergency consultation of a 27-year-old Swiss–German man lacking known previous medical conditions who developed an episode of anxiety and panic due to pain in the left chest prompted by over-interpretation of unremarkable electrocardiogram readings of his smartwatch. Fearing acute coronary syndrome, he presented at the emergency department. His smartwatch electrocardiograms, as well as a 12-lead electrocardiogram, appeared normal. After extensive calming and reassuring, as well as symptomatic therapy with paracetamol and lorazepam, the patient was discharged with no indications for further treatment. CONCLUSIONS: This case demonstrates the potential risks of anxiety from nonprofessional electrocardiogram recordings by smartwatches. Medico–legal and practical aspects of electrocardiogram recordings by smartwatches need to be further considered. The case shows the potential side effects of pseudo-medical recommendations for the untrained consumer, and may add to the discussion on the ethics of how to evaluate smartwatch electrocardiogram data as a medical professional.