STEMI occurs when a major artery is totally blocked; less severe heart attacks can occur when an artery is only partially blocked. The most common way to find out if a patient is suffering a STEMI is through an electrocardiogram (EKG) test. Physicians use EKG results to determine if blood is flowing to the heart. When no flow is present, it signals that the heart muscle is dying and action must be taken immediately to restore blood flow. Permanent damage to the heart muscle can lead to congestive heart failure or death.
"The key to treating STEMI patients is the EKG," says East Jefferson General Hospital (EJGH) cardiologist Dr. David Snyder. "Being able to quickly assess and identify that a person is having a STEMI event sets all the other pieces in motion so that everyone on that patient's medical team can act rapidly."
In most cases, the best treatment option is for an interventional cardiologist to insert a balloon into the blocked artery to reopen it. Commonly performed in a catheterization lab (cath lab), the cardiologist can follow insertion of the balloon with a wire stent placed in the blocked area to help keep the artery open.
The current goal set forth by the AHA and the American College of Cardiology is to have a STEMI patient in the cath lab with blood flow restored to the coronary artery no more than 90 minutes after he or she arrives at the hospital (commonly referred to as door-to-balloon time). These organizations are expected to change the goal to 90 minutes or less from the first medical contact to the time a balloon is inserted and blood flow is restored. The difference is that the new guideline will start the 90-minute countdown when a paramedic first begins on-site treatment in the field.
"Saving the life is not enough," says EJGH cardiologist Dr. Stanley Bleich. "We know the longer someone goes without blood flow and oxygen, the greater the risk of dying or suffering permanent heart muscle or organ damage. We want that blood flow restored and to have the heart returned to normal function as quickly as possible."
Physicians stress that people who think they are having a heart attack should immediately call 911 — and not drive themselves to the hospital. Advances in mobile EKG technology in ambulances allow paramedics who respond to a call to administer a diagnostic-quality EKG and instantly transmit the results to the hospital so medical teams in the emergency room and cath lab can be informed of the patient's condition and prepared for his arrival. This advanced notification can make a difference in the patient's survival and long-term quality of life.