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Acute Coronary Syndromes: STEMI

Reviewed 06/2020
 


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

  • See “Medication” for ED management.

  • Following emergent revascularization, admit the patient to the coronary care unit (CCU) or a telemetry unit with continuous ECG monitoring ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • Emphasize medica...

REFERENCES

1
Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the manageme...

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

  • STEMI occurs from occlusion of one or more coronary arteries resulting in transmural myocardial ischemia.

  • Early revascularization with percutaneous coronary intervention (PCI) within 90...

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