| STEMI - ST
Elevation Myocardial Infarction |
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A severe heart
attack caused by a prolonged period of blocked blood supply that affects
a large area of the heart. These attacks carry a substantial risk of
death and disability and call for a quick response by many individuals
and systems.
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In a STEMI, the coronary artery is completely blocked
off by the blood clot, and as a result virtually all the heart muscle
being supplied by the affected artery starts to die. This more severe
type of heart attack is usually recognized by characteristic changes
it produces on the ECG.
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One of those ECG changes is a characteristic elevation
in what is called the "ST segment." The elevated ST segment
indicates that a relatively large amount of heart muscle damage is
occurring (because the coronary artery is totally occluded), and is
what gives this type of heart attack its name.
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Treatment |
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Emergency PCI is the preferred treatment of STEMI when
available in a timely fashion (door to balloon-inflation time < 90
min) by an experienced operator. Indications for urgent PCI later in
the course of STEMI include hemodynamic instability, malignant arrhythmias
requiring transvenous pacing or repeated cardioversion, and age > 75.
If the lesions necessitate CABG, there is about 4 to 12% mortality
and a 20 to 43% morbidity rate. |
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STEMI Alert - Notes
of a Paramedic |
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We arrive at the office building, and on entering, find a crowd
of people standing around a cubicle. A young man lies on the ground
by his desk. He is shivering. He is covered up to the neck with
winter coats. He is ghostly pale. There is vomit in the waste basket.
I touch his forehead and it is as soggy as a sponge.
 I ask
him how he is doing, he answers in a forced whisper which I can’t
understand. My plan is to just get him out to the ambulance and
out of the sight of others and try to figure out what is going
on. I am wondering if maybe he doesn’t have a stomach bug
or something. He looks perfectly fit, except he is so pale.
In the ambulance, I help sit him up so I can get his shirt off, which is soaked through with sweat. We put him on a cannula and I attach the monitor while my partner tries to get a quick blood pressure. The young man tells me he has been feeling weak with pains in his arms for about forty minutes. He says he vomited twice.......
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A true extract
from a report prepared by a paramedic
Let's hope he is not writing
about you in his next report. |
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Peter Scott - Team Leader
