ST-elevation myocardial infarction

ST-elevation myocardial infarction (STEMI) presents with central chest pain that is classically heavy in nature, like a sensation of pressure or squeezing. Examination is variable, and findings range from normal to a critically ill patient in cardiogenic shock.

STEMI is suspected when a patient presents with persistent ST-segment elevation in two or more anatomically contiguous ECG leads in the context of a consistent clinical history.

Cardiac biomarkers (e.g., cardiac-specific troponins) confirm diagnosis. Treatment should, however, be started immediately in patients with a typical history and ECG changes, without waiting for laboratory results.

Immediate and prompt revascularization can prevent or decrease myocardial damage and decrease morbidity and mortality.

About 15% of patients in the US who have an acute myocardial infarction (MI) will die of it.

Survivors of acute MI should be closely followed up for adequate modification of risk factors and development of complications.

Myocardial infarction is the irreversible necrosis of heart muscle that occurs because of a prolonged mismatch between perfusion and demand.[1]Anderson HVS, Masri SC, Abdallah MS, et al. 2022 ACC/AHA Key data elements and definitions for chest pain and acute myocardial infarction: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Data Standards. Circ Cardiovasc Qual Outcomes. 2022 Oct;15(10):e000112. https://www.doi.org/10.1161/HCQ.0000000000000112 http://www.ncbi.nlm.nih.gov/pubmed/36041014?tool=bestpractice.com This is usually caused by occlusion in the coronary arteries. ST-elevation myocardial infarction (STEMI) is suspected when a patient presents with persistent ST-segment elevation in two or more anatomically contiguous ECG leads in the context of a consistent clinical history.