Project UPSTART: the Use of Procedural Standardization to Reduce Recognition to Repferfusion (R2R) Time in ST-Elevation Myocardial Infarction (STEMI)

Training Tutorial 1.2

What Exactly is STEMI?

STEMI is a subset of heart attacks that is identified by characteristic changes on the electrocardiogram (ECG). This usually occurs as an unusual elevation of the ST segments in various leads. Most commonly, ST-segment elevation occurs in multiple leads that are measuring electrical changes in a region(s) of the heart supplied by a specific coronary artery. For example you might hear of an inferior (figure 2), anterior (figure 3), or anterior-lateral (figure 4) STEMI, each defining a specific region of the heart that is being damaged.

In addition to STEMI, other forms of heart attack occur that do not show up on the ECG as ST-segment elevation. These heart attacks also need to be treated quickly and efficiently but they don’t necessarily benefit from immediate emergency reperfusion like STEMI patients do. So the ECG is key, helping us quickly discover those exact heart attacks that demand emergent catheterization or thrombolytic therapy.

Remember: It’s the ECG that will tell you “STEMI or not!”

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