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Acute Coronary Syndromes: STEMI

Yutthapong Temtanakitpaisan, MD, FACC, FSCAI Reviewed 04/2024
 


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

  • Symptoms:

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

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

TREATMENT

GENERAL MEASURES

  • Following emergent revascularization, admit the patient to the coronary care unit (CCU) or a telemetry unit with continuous ECG monitoring and bed rest, and use:

    • Antiarrhythmi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

STEMI patients should follow up with a cardiologist 1–2 weeks postdischarge, every 3 months for the first year, and then yearly. Emphasize medication adherence an...

REFERENCES

1
Di Marco A, Rodriguez M, Cinca J, et al. New electrocardiographic algorithm for the diagnosis of acute myocardial infarction in patients with left bundle branch block. J Am Heart Assoc. 20...

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

SNOMED

  • 3...

CLINICAL PEARLS

Early revascularization with PCI within 90 minutes of presentation at a PCI-capable hospital, or within 120 minutes if transfer to a PCI capable hospital is required. Fibrinolytic ther...

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