Acute Coronary Syndromes: STEMI

Reviewed 06/2018
 


BASICS

DESCRIPTION

Acute myocardial infarction (AMI) is the rapid development of myocardial necrosis resulting from a sustained and complete absence of blood flow to a portion of the myocardium. ST-seg...

DIAGNOSIS

HISTORY

  • Classically, sudden onset of chest heaviness/tightness, with or without exertion, lasting minutes to hours

  • Pain/discomfort radiating to neck, jaw, interscapular area, upper extremities...

TREATMENT

GENERAL MEASURES

  • Following emergent revascularization, admit to telemetry/coronary care unit (CCU) with continuous ECG monitoring and bed rest. Anxiolytics, if needed; stool softeners

  • Antiarrh...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Emphasize medication adherence. Identify high-risk patients for implantable cardioverter defibrillator (ICD) placement (especially those with EF <30%). Conside...

REFERENCES

1 O’Gara PT, Kushner FG, Ascheim DD, et al; for CF/AHA Task Force. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the Amer...

CODES

ICD10

  • I24.9 Acute ischemic heart disease, unspecified

  • I21.3 ST elevation (STEMI) myocardial infarction of unspecified site

  • I25.10 Athscl heart disease of native coronary artery w/o ang pctrs

ICD9

  • 411...

CLINICAL PEARLS

For elective surgeries in patients on DAPT, it is recommended to wait until completion of mandatory regime and continue ASA perioperatively. 

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