How do you know if its a STEMI?

Classically, STEMI is diagnosed if there is >1-2mm of ST elevation in two contiguous leads on the ECG or new LBBB with a clinical picture consistent with ischemic chest pain. Classically the ST elevations are described as “tombstone” and concave or “upwards” in appearance.

What is the difference between MI and STEMI?

Myocardial infarction is the medical term for a heart attack. An infarction is a blockage of blood flow to the myocardium, the heart muscle. That blockage causes the heart muscle to die. A STEMI is a myocardial infarction that causes a distinct pattern on an electrocardiogram (abbreviated either as ECG or EKG).

What medication is given for STEMI?

P2Y12 inhibitors P2Y12 receptor antagonists (clopidogrel, prasugrel, ticagrelor (Brilinta, AstraZeneca) and ticlopidine) are indicated in all STEMI cases unless urgent surgery is required. Clopidogrel can also be used as an adjunct to fibrinolytic therapy in aspirin-intolerant patients.

Do you give fluids in STEMI?

Abstract. Adequate hydration is recommended for acute ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) to prevent contrast-induced nephropathy (CIN).

What size is ST elevation?

An ST elevation is considered significant if the vertical distance inside the ECG trace and the baseline at a point 0.04 seconds after the J-point is at least 0.1 mV (usually representing 1 mm or 1 small square) in a limb lead or 0.2 mV (2 mm or 2 small squares) in a precordial lead.

What is non Q wave MI STEMI?

Non-ST elevation MI (previously termed non-Q wave MI, often referred to as non-STEMI), is an unstable coronary syndrome which is differentiated from unstable angina by a subsequent rise in cardiac enzymes. ECG findings often include ST depression but do not include new pathological Q waves.

When do you give GTN to STEMI?

If the patient is hypertensive (>180/110), then a GTN infusion may be commenced to bring the blood pressure below this level, before giving thrombolysis.

Why is aspirin given in STEMI?

Given during infarction, aspirin may disaggregate platelet microthrombi and may reduce the size of a developing thrombus. Effects of aspirin other than on platelets have also been suggested and these include an increase in the permeability of a fibrin clot and an enhancement of clot lysis.

Is heparin given in STEMI?

Conclusion. The practice of giving STEMI patients anticoagulation has never been based on strong evidence. There are no trials of heparin in STEMI patients undergoing PCI, and the trials of heparin in thrombolysed patients are mixed and have significant flaws.

What is type 5 myocardial infarction?

Coronary artery bypass grafting (CABG)–related MI is termed type 5 MI. Coronary procedure–related MI ≤48 hours after the index procedure is arbitrarily defined by an elevation of cTn values >5 times for type 4a MI and >10 times for type 5 MI of the 99th percentile URL in patients with normal baseline values.