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A heart attack, or myocardial infarction (MI), occurs when a coronary artery becomes blocked by a blood clot. ST-segment elevation myocardial infarction (STEMI) is a complete blockage, while non-ST-segment elevation myocardial infarction (NSTEMI) is partial. Symptoms include chest pain, shortness of breath, and sweating. Treatment includes drugs to destroy the clot or surgery to widen or bypass the blocked artery. Women may experience different symptoms than men.
A myocardial infarction (MI), commonly referred to as a heart attack, occurs if a patient’s coronary artery, an artery that wraps around the heart and supplies the blood supply to it, becomes blocked to some extent by a blood clot. In a ST-segment elevation myocardial infarction (STEMI), the patient’s coronary artery is completely blocked. Once the blood supply is cut off, heart tissue that has been supplied with blood from the coronary artery can, if left untreated, heart attack, another word for death.
The motion of the heartbeat is often measured by an echocardiogram (ECG), a device that measures electrical impulses from the heart and uses certain letters to label parts of the process. The “ST” in ST-segment elevation myocardial infarction is the portion of the heartbeat where there should be little or no electrical activity; it usually appears as a flat line on an ECG graph. When a patient’s ST segment is elevated, it indicates that there is electrical activity and this in turn usually indicates that there is lack of blood flow to the heart.
There are two subcategories of myocardial infarction: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). NSTEMI is the less severe of the two, indicating only partial blockage of the coronary artery; STEMI is a complete block. Both STEMI and NSTEMI often have similar symptoms but are treated slightly differently, depending on the level of severity.
Typical symptoms of both STEMI and NSTEMI are sudden chest pain usually radiating to the left side of the neck and down the left arm, shortness of breath, anxiety, and sweating. There may also be nausea, vomiting and palpitations. There may also be no symptoms or what is known as a “silent” myocardial infarction. This happens about 25% of the time. It’s also important to know that women usually don’t have the same typical symptoms as men; they often have indigestion, weakness, nausea, and shortness of breath.
Treatment for ST-segment elevation myocardial infarction is usually with drugs that destroy the clot, a process known as thrombolysis. The drugs contain enzymes that interfere with the fibers that form the clots, eventually breaking them down and clearing the artery. If it’s more serious, a procedure known as an angioplasty is done. Angioplasty, referred to as percutaneous coronary intervention when performed on the heart, is a surgical procedure that widens blood vessels by placing a catheter and balloon inside them. The balloon is expanded to widen the vessel and break up the deposits causing the blockage.
NSTEMI is treated with drugs to keep the arteries open. Sometimes percutaneous coronary surgery is done, typically when a patient first arrives at the hospital if the blockage is more severe. If there are many blockages and the patient is stable enough, coronary artery bypass surgery may be done. This procedure can be performed for both STEMI and NSTEMI.
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