STEMI

What is a STEMI?
STEMI stands for ST-elevated myocardial infarction, which is a severe and life-threatening type of heart attack. A STEMI occurs when a coronary artery becomes suddenly and completely blocked, preventing the oxygen-rich blood from reaching a portion of the heat muscle. Without quick treatment, the affected heat tissue can be permanently damaged or destroyed.

STEMI heart attacks are medical emergencies and require immediate diagnosis and rapid treatment to restore blood flow and limit heart damage.

What Does ST-Elevation Mean?
ST elevation refers to a specific change seen on an electrocardiogram (ECG or EKG), a test that shows the electrical activity in the heart.

Who is Affected?
STEMI can affect anyone, but it is more common in older adults and those with underlying heart disease or cardiovascular risk factors.

What Causes a STEMI?
A STEMI is most commonly caused by the rupture of an atherosclerotic plaque within a coronary artery. This rupture triggers the formation of a blood clot that fully blocks the blood flow to the heart muscle.

Risk Factors

Not Controllable

• Increasing age
• Family history of, or genetic predisposition to, heart disease
• Genetic predisposition to cardiovascular disease
  
  

Controllable

• High blood pressure
• High cholesterol
• Smoking or tobacco use
• Diabetes (uncontrolled)
• Obesity
• Physical inactivity
• Poor diet
• Chronic stress
  
  

Who is Most at Risk?
People with multiple cardiovascular risk factors, a history of coronary artery disease or prior heart attacks are at higher risk, Smoking and uncontrolled diabetes significantly increase the likelihood of STEMI.

Steps to Reduce Your Risk

• Maintain healthy blood pressure and cholesterol levels
• Follow a heart-healthy diet
• Engage in regular physical activity
• Quit, or don’t start, smoking
• Manage diabetes effectively
• Maintain a healthy weight
• Manage stress
• Prioritize sleep
  
  

Learn more about cardiovascular wellness and managing the risk factors that can lead to heart attacks.

Symptoms of Heart Attacks, including STEMI:

• Chest pressure, squeezing, aching or burning
• Shortness of breath
• Pain in the jaw, back or pain that travels down one or both arms
• Feeling of fullness, nausea, vomiting or breaking out in a cold sweat
• Anxiety
• Excessive fatigue or weakness
  
  

Print your own heart attack and stroke signs and symptoms.

How is STEMI Diagnosed?
STEMI is diagnosed quickly based on symptoms, physical examination and diagnostic testing. Time is critical, as faster diagnosis leads to better outcomes.

When a STEMI is suspected by the EMS crew in the ambulance based on symptoms, physical exam and EKG, they will communicate with the emergency department so a STEMI Code can be activated, gathering the needed clinical team as quickly as possible.

Diagnostic Tests Often Used:

• Electrocardiogram (ECG or EKG) to identify ST-segment elevation
• Blood tests to measure cardiac enzymes such as troponin
• Coronary angiography to locate arterial blockages
• Echocardiogram to assess heart function
• Chest imaging when needed to rule out other conditions
  
  

Learn more about cardiac diagnostics.

How is STEMI Treated?
Treatment focuses on restoring blood flow to the blocked coronary artery as quickly as possible and preventing further damage. This is usually done with an interventional cardiology procedure first, with the lifestyle and medication treatments noted below used after the procedure to try to prevent additional cardiac events problems.

Lifestyle

• Cardiac rehabilitation
• Smoking cessation
• Heart healthy diet
• Physical activity
• Stress management
  
  

Devices

• Coronary stents to keep arteries open
• Temporary pacing devices if rhythm disturbances occur
  
  

Medical

• Antiplatelet medications
• Blood thinners
• Clot dissolving medications if procedural interventions are not an option
• Beta blockers
• ACE inhibitors or ARBs
• Cholesterol-lowering medications
  
  

Procedural & Surgical

• Percutaneous coronary intervention (PCI), commonly known as angioplasty or cardiac catheterization
• Coronary Artery Bypass Grafting (CABG) in select cases

When to Seek Care

When to Talk to Your Doctor

• If you have risk factors for heart disease
• If you experience recurring chest discomfort or unexplained shortness of breath
• If you need help managing your blood pressure, cholesterol or diabetes
  
  

When to Seek Emergency Medical Care
Call 911 immediately if you experience heart attack symptoms.

• Chest pressure, squeezing, aching or burning
• Shortness of breath
• Pain in the jaw, back or pain that travels down one or both arms
• Feeling of fullness, nausea, vomiting or breaking out in a cold sweat
• Anxiety
• Excessive fatigue or weakness
  
  

Arrive alive. Do not drive yourself to the hospital. Always call 911.