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...
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...
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 and...
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
3...
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Acute infero-postero myocardial infarction.
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surrounded by smooth muscle cells. <bold>B.</bold> Endothelial cell activation or injury recruits monocytes and T lymphocytes to the site of injury, leading to development of a fatty streak. <bold>C.</bold> Continued oxidative stress within a fatty streak leads to development of an atherosclerotic plaque. <bold>D.</bold> Macrophage apoptosis and co...
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surro...
Acute anterior myocardial infarction. Transmural injury is manifested by ST-segment elevation of greater than 0.2 mV in leads V1 to V3.
Myocardial infarction, ST elevation.
<bold>FIGURE 26-10</bold> (<bold>Top</bold>) (<bold>A</bold>) ECG tracing showing normal P, Q,R,S, and T waves. (<bold>B</bold>) ST elevation with acute ischemia. (<bold>C</bold>) Q wave with acute myocardial infarction. (<bold>Bottom</bold>) Current-of-injury patterns with acute ischemia. With predominant subendocardial ischemia (<bold>A</bold>), the resultant ST segment is directed toward the inner layer of the affected ventricle and the ventricular cavity. Overlying leads therefore record ST-segment depression. With ischemia inv...
<bold>FIGURE 26-10</bold> (<bold>Top</bold>) (<bold>A</bold>) ECG tracing showing normal P, Q,R,S, and ...
Acute myocardial infarct. A cross-section of the ventricles of a man who died a few days after the onset of severe chest pain shows a transmural infarct in the posterior and septal regions of the left ventricle. The necrotic myocardium is soft, yellowish, and sharply demarcated.
Acute myocardial infarct. A cross-section of the ventricles of a man who died a few days after the onset of severe chest pain shows a trans...