Via practica 4/2017

STEMI – principles of timely management

Acute coronary syndromes represent leading cause of mortality in developed countries. Two categories of patients may be encountered:

1. myocardial infarction with persistent ST segments elevation (STEMI) and 2. acute coronary syndrome without ST segment elevation (NSTEACS). In STEMI total occlusion of coronary artery prevails and rapid reperfusion by primary angioplasty or fibrinolytic therapy is the main therapeutic objective. Successful and persistent reperfusion may influence myocardial infarction size and preserve left ventricular systolic function. The aim of the paper is to explain in practice and in a simplified way the STEMI timely management of healthcare professionals who are first faced with patients with acute heart attacks and are involved in rapid diagnosis of STEMI (rescuers, general practitioners, emergency doctors, doctor of internal medicine, cardiologists). Early management of STEMI requires the fastest diagnosis (ECG diagnosis within 10 minutes of first medical contact), treatment, and immediate transportation by the emergency medical service directly to the cardiocentre.

Keywords: myocardial infarction with ST segments elevation (STEMI), timely and early management, time intervals, primary PCI (pPCI), emergency medical service (EMS)