What is a STEMI Myocardial Infarction?

STEMI stands for ST elevated myocardial infarction, which is the clinical name given to a major heart attack, and describes the wave pattern displayed by an electrocardiogram when the heart attack is occurring. STEMI occurs when one of the coronary arteries becomes completely blocked, cutting off the flow of oxygen-rich blood to a section of the heart.

STEMI is a life-threatening condition. If you suspect you or someone else is having a heart attack, call 9-1-1 and wait for emergency help to arrive. Unless blood flow to the impacted area is restored quickly, the heart muscle begins to die, causing permanent damage and possible cardiac arrest and death.

Baptist Health is known for advanced, superior care for patients with heart problems and the diagnosis, treatment and management of STEMI. Baptist Health is an accredited American Association Mission Lifeline Receiving Center, meaning patients being treated will benefit from the most advanced, superior care in the diagnosis, management and treatment of heart attacks.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

STEMI Myocardial Infarction Signs and Symptoms

Conditions that can lead to a STEMI develop gradually, and often show no symptoms. That’s why it’s important to have regular checkups and take preventative measures if you are at risk.

Chest discomfort, pain or pressure is often the first and most obvious symptom of a STEMI. It may be described as a heaviness, aching, tightness, throbbing or constriction. This discomfort is usually located in the center or left side of the chest, though it may also occur in the jaw, neck, back, arms or upper part of the stomach, and occasionally only at these secondary sites. Other symptoms may include:

• Shortness of breath
• Fatigue
• Dizziness or lightheadedness
• A cold sweat
• Nausea and vomiting

STEMI Myocardial Infarction Diagnosis

An early diagnosis of a STEMI is critical to limit damage to the heart and prevent cardiac arrest. If you suspect you or someone else is having a heart attack, call 9-1-1 and wait for emergency help to arrive. Common diagnostic procedures can include:

Blood test: Blood tests check the levels of certain fats, cholesterol, sugar and protein in the blood that could indicate heart conditions.

Chest X-ray: A common imaging test of the lungs, heart and aorta.

Coronary angiography: During this test, a thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show any blood clots or other blood vessel issues.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Radionuclide imaging (thallium stress test): This non-invasive procedure can identify if there is severe heart damage. A radioactive isotope is injected into a vein and a special camera or scanner records how it travels through the heart. Any heart damage can be plotted, locating the damaged area of the heart. This procedure can be done with an electrocardiogram, during both rest an exercise.

STEMI Myocardial Infarction Causes

STEMI causes can include:

• Buildup of plaque – fat, cholesterol and other cellular waste – on artery walls
• Drugs, including cocaine and excessive alcohol
• Smoking
• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Overexertion
• Stress

Risk Factors

STEMI risk factors can include:

Age: Men over 50 with a family history of heart disease and women after menopause ends are at greater risk for STEMI heart attacks.

Family history: People with a family history of heart disease are at higher risk for heart attack.

Infection: Some infections when left untreated, like syphilis or salmonella, can lead to heart attack.

Race and ethnicity: African-Americans have a higher risk of heart disease that can cause a heart attack, due in part to severe high blood pressure, diabetes and obesity.

Prevention

While some risk factors like age and heredity cannot be controlled, there are ways you can help to prevent a heart attack:

Eat heart-healthy foods: Limit your salt, sugar and unhealthy fat intake.

Exercise: 30 minutes of aerobic exercise at least five days per week can help prevent heart attacks.

Avoid use of tobacco and cocaine: Both have significant risk for causing heart attack.

Limit alcohol use: Talk with your physician about the amount and types of alcohol you can consume.

Manage stress: Take a stress management course, learn about biofeedback, mediate, do yoga or aerobic exercise and discuss with family and friends about problems.

Take your medications as prescribed: If you have high blood pressure, high cholesterol, diabetes, anxiety or depression, be certain to take your prescribed medications as directed.

STEMI Myocardial Infarction Prognosis

Prognosis depends upon how quickly the heart attack is treated. If treatment occurs within the first several hours when symptoms are first experienced, damage to the heart can often be prevented or limited. If the artery is still blocked after three hours, some permanent damage is likely, and the amount of damage increases with every passing minute, as does the risk of cardiac arrest. Permanent damage to the heart can have lasting consequences and put you at greater risk for repeated heart attacks and other heart conditions. The damaged tissue will not regenerate and the undamaged part of the heart will be forced to work harder to meet the body’s needs.

Treatment and Recovery

Immediate emergency care is needed when symptoms of a STEMI are first experienced. If you or someone else is experiencing symptoms or are not sure, call 9-1-1 and wait for an ambulance.

Immediate Treatment

Immediate treatment for STEMI focuses on removing the blockage from the artery and restoring blood flow to the heart as quickly as possible. This may be accomplished either with thrombolytic therapy (“clot-busting” drugs), or by a coronary angioplasty (a procedure that uses a catheter with a small balloon to open the artery, and a mesh stent placed at the site of the blockage to prevent reclosing). Additional immediate treatments that may be given include:

• Anticoagulants
• Medication to slow or calm the heart
• Pain medication
• Oxygen

Surgical Options

In addition to the immediate treatment, the cardiologist may recommend the following surgical procedures to better restore flood flow and help prevent future heart attacks:

• Coronary artery bypass grafting: Depending on the damage done to the artery that was blocked and plaque buildup discovered in other major arteries, the cardiologist may recommend bypass surgery. This is done by harvesting arteries or veins from your legs or chest and using them to bypass the affected areas in order to restore proper blood flow to the heart. In some cases, this can be done as a minimally invasive procedure that will keep you in the hospital for two to three days. In most cases, however, you can expect to be in the hospital for about a week, and miss four to six weeks of work.
  
  

Medications

Once the immediate threat from the blocked artery has been addressed, your doctor may prescribe the following medications to help prevent future heart attacks:

• Anticoagulants: Your doctor will likely recommend taking aspirin to help reduce inflammation, thin your blood and prevent clotting, and may prescribe other anticoagulants or drugs that dissolve clots. 
• Statins: Statins are a class of drug that help lower cholesterol levels. 
• Vasodilators: Vasodilators like nitroglycerin are drugs that dilate your blood vessels, lowering your blood pressure and making it easier for blood to flow.

Cardiac Rehabilitation Programs

If you have had a STEMI, your doctor will likely recommend a Cardiac Rehabilitation Program. These programs provide an exercise regimen specifically designed to help you slowly strengthen your heart, and make other diet and lifestyle changes that will reduce your risk of another heart attack, heart failure, and other complications.

Complications

STEMI is the deadliest form of heart attack, and can cause permanent damage to the heart within a few hours. Other complications can include:

Heart conditions and stroke: A STEMI increases the risk for repeated heart attacks, heart arrhythmias, heart failure, trans ischemic attacks and stroke.

Anxiety and depression: A STEMI can also result in anxiety and depression, which is associated with worrying about health.