Heart Attack Due to Severely Reduced Blood Flow (STEMI): Recognizing Signs and Further Details

Heart Attack Due to Severely Reduced Blood Flow (STEMI): Recognizing Signs and Further Details

In the realm of cardiovascular health, a STEMI heart attack stands as a significant concern. This type of heart attack, an acute coronary syndrome (ACS), is caused by a complete blockage of a coronary artery, often resulting in the death of a portion of the heart muscle [1].

Symptoms of a STEMI heart attack can vary between individuals, but chest pain, tightness, or a crushing feeling in the chest is the most common symptom [2]. Other symptoms may include sweating, shortness of breath, nausea or vomiting, pain in the jaw, neck, back, or arms, and dizziness or lightheadedness [2]. It's essential to seek medical attention immediately if these symptoms occur, as every second is crucial during a STEMI heart attack [3].

The body's response to the arterial injury is the formation of blood clots, which can block the artery, leading to a STEMI heart attack [4]. Risk factors for STEMI heart attacks include dyslipidemia, diabetes, high blood pressure, smoking, and a family history of coronary artery disease [5].

Treatment options for STEMI heart attacks are designed to rapidly restore blood flow to the blocked coronary artery and minimise heart muscle damage. The primary treatment options include:

1. Primary percutaneous coronary intervention (PCI): This is the preferred first-line therapy, ideally performed within 90 minutes of first medical contact. PCI involves catheter-based balloon angioplasty and usually stent placement to open the occluded artery and restore blood flow [4][5].
2. Thrombolytic (fibrinolytic) therapy: For patients who cannot access PCI quickly, clot-dissolving drugs are administered intravenously or intracoronarily to dissolve the thrombus blocking the artery, improving myocardial perfusion [1][5].
3. Coronary artery bypass graft surgery (CABG): This surgical option is considered in some complicated cases when PCI is not feasible or in multivessel coronary artery disease [5].

Adjunctive therapies include antiplatelet agents, anticoagulants, beta blockers, ACE inhibitors or ARBs, and aldosterone antagonists [2]. Deferred stenting, where PCI is performed initially with balloon angioplasty to restore flow, then stenting is delayed after antithrombotic therapy reduces thrombus burden, is also an option [1].

Long-term management after the acute event focuses on preventing recurrence, including lifestyle changes, high-intensity statins, risk factor control (hypertension, diabetes), and continued antiplatelet therapy [2].

The location of the blockage, amount of heart muscle damaged, age, overall health status, and how quickly medical attention is received can affect a person's outlook after a STEMI heart attack. The in-hospital death rate for STEMI heart attacks ranges from around 10% at 1-year follow-up, but can increase if complications arise before reaching the hospital [6].

The best way to prevent heart attacks is through lifestyle measures such as quitting smoking, eating a balanced diet, managing weight, increasing physical activity, reducing stress levels, managing blood pressure and cholesterol levels, and managing diabetes [7]. It's crucial to discuss heart health with your doctor to determine the best preventive measures for you.

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