Gentile’s Sign*: Bedside Diagnosing Acute Myocardial Infarction, even initial or silent.

Bedside diagnosing Acute Myocardial Infarction (AMI) is sometimes very difficult, particularly if initial or silent. On the other hand, the efficaciousness of therapeutic results, especially regarding mortality rate, depend of early AMI diagnosis (1-7).
In following, a Quantum Biophysical Semeiotics simple method, easily and quickly to apply, based on Gentile’s Sign, is fully illustrated.
Considering that glucose and lipid metabolism impairment worsens, BUT not brings about coronary artery disease (CAD), as I have demonstrated earlier (3-8), physician has to know CAD Inherited Real Risk, rapidly detected with the Caotino’s Sign (8), representing the condition sine qua non of CAD, especially in individuals involved by hypertension, diabetes mellitus, dyslipidemia, or elevated C-reactive protein.
In my long, well-established clinical experience, Gentile’s Sign proved to be really useful also in order to bed-side recognizing AMI, even silent or initial: impending infarction.
Importantly, it is known that patients with CAD may have no symptoms at all for many years or decades and that the electrocardiographic features of ischemia may be induced by exercise without accompanying angina (2, 7, 8). As a consequence, physicians need a clinical tool reliable in rapid detecting CAD, even clinically silent, initiating from CAD “inherited real risk. From the practical viewpoint, in order to apply Gentile’s Sign doctor has to know, at least, the auscultatory percussion of the stomach (1).
In health, digital pressure of “mean” intensity (= stimulation of both upper and lower ureteral reflex: vasomotility and respectively vasomotion, according to Hammersen), applied upon ventricle heart skin projection area = precordium), brings about the so-called gastric aspecific reflex (= in the stomach, fundus and body are dilated, while antral-pyloric region contracts) after a latency time of 8 sec. exactly; reflex duration is less than 4 sec. (= parameter value of paramount significance since it parallels the efficacy of local coronary microvessel Microcirculatory Functional Reserve). Finally, the reflex disappearing is > 3 sec. < 4 sec. (= parameter value paralleling fractal Dimension of local microcirculatory oscillations) (1-4) (Fig. 1).
On the contrary, in impending infarction and obviously in overt AMI, even silent or initial, latency time appears significantly lowered to 3-5 sec, in inverse relation with the seriousness of underlying disorder (NN = 8 sec.). Reflex lasts longer than normal: 4 sec. or more (NN = > 3 sec. < 4 sec.), directly correlated with the AMI severity.
Finally, nail-digital pressure on identical heart trigger-points, illustrated above, only in AMI patients bring about gastric aspecific refelex after a reduced latency time: 3-5 sec. (NN = 10 sec. or more)
When physicians will be able to apply Gentile’s Sign, and Caotino’s Sign, both morbidity and mortality caused by AMI will lowered significantly, and CAD will not be, as nowadays, a growing epidemics.

*Anna Gentile, MD. My Cardiologist, Sestri Levante Hospital, ASL 4, (Genova) Italy

References

1)Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/ semeiotica_biofisica.htm
2)Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.
3)Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php

4)Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004

5) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, 2009.

6)Stagnaro S. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [MEDLINE]

7) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn- Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp

8) Sergio Stagnaro. Caotino’s Sign in bedside detecting CAD, since its initial Stage of CAD Inherited Real Risk. www.fce.it. 3 giugno 2010. http://www.fceonline.it/images/docs/caotino.pdf