What is STEMI diagnosis?
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.
How is MI diagnosed?
Acute myocardial infarction is myocardial necrosis resulting from acute obstruction of a coronary artery. Symptoms include chest discomfort with or without dyspnea, nausea, and diaphoresis. Diagnosis is by ECG and the presence or absence of serologic markers.
How is STEMI and NSTEMI diagnosed?
Diagnosing an NSTEMI NSTEMI is diagnosed through a blood test and an ECG. The blood test will show elevated levels of creatine kinase-myocardial band (CK-MB), troponin I, and troponin T. These markers are evidence of possible damage to the heart cells, and are typically mild compared with STEMI.
What are the types of STEMI?
The three types of heart attacks are: ST segment elevation myocardial infarction (STEMI) non-ST segment elevation myocardial infarction (NSTEMI) coronary spasm, or unstable angina.
What is STEMI in ECG?
A STEMI is a myocardial infarction that causes a distinct pattern on an electrocardiogram (abbreviated either as ECG or EKG). This is a medical test that uses several sensors (usually 10) attached to your skin that can detect your heart’s electrical activity.
What is STEMI treatment?
The priority in treating a STEMI heart attack is to open the artery quickly, saving as much heart muscle as possible. Treatment options include percutaneous coronary intervention (PCI), a term that encompasses both angioplasty and stenting; clot-busting medication; and coronary artery bypass graft surgery (CABG).
Why is CBC used for myocardial infarction?
Obtain a complete blood cell (CBC) count if myocardial infarction (MI) is suspected in order to rule out anemia as a cause of decreased oxygen supply and prior to giving thrombolytic agents. Leukocytosis is also common, but not universal, in the setting of acute myocardial infarction.
What are troponin tests?
A troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
What are the 3 cardiac enzymes?
Cardiac enzymes ― also known as cardiac biomarkers ― include myoglobin, troponin and creatine kinase.
What is V3 in ECG?
V3, V4 = septum. V5, V6 = L side of the heart. Lead I = L side of the heart. Lead II = inferior territory.
What is transmural infarction?
A transmural myocardial infarction refers to a myocardial infarction that involves the full thickness of the myocardium. It was one believed that the development of Q waves indicated the infarction was “transmural;” however, autopsy studies failed to confirm this.
What is the best treatment for STEMI?
What is STEMI (STEMI)?
It is a clinical syndrome involving myocardial ischemia, EKG changes and chest pain. An acute ST-elevation myocardial infarction (STEMI) is an event in which transmural myocardial ischemia results in myocardial injury or necrosis.[1]
What are atypical presentations of STEMI (STEMI)?
Atypical presentations can occur in the elderly, women and in diabetic persons. If the initial ECG is non-diagnostic, it may need to be repeated at frequent intervals to detect evolving changes of STEMI. Additional chest leads (V 7-9) and right ventricular leads may also be helpful.
What is the preferred treatment for STEMI?
•Primary PCI is the preferred treatment for STEMI –At a hospital with PCI, the goal is PCI within 90 minutes –At a hospital without PCI, the goal is transfer and PCI within 120 minutes –If transfer for PCI within 120 minutes is not feasible, use fibrinolytic therapy unless contraindicated, with a door-to-needle time less than 30 minutes
What is the role of non-invasive imaging in the evaluation of STEMI?
Non-invasive imaging is very important for the acute investigation of patients with an unclear diagnosis or suspicion of STEMI complications and for long-term management of STEMI patients after reperfusion. MINOCA A sizeable proportion of STEMI patients do not present significant coronary artery stenosis on urgent angiography.