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{{  Name          = Myocardial infarction|
__NOTOC__
  DiseasesDB    = 8664 |
{| class="infobox" style="float:right;"
  ICD10          = {{ICD10|I|21||i|20}}-{{ICD10|I|22||i|20}} |
|-
  ICD9          = {{ICD9|410}} |
| [[File:Siren.gif|30px|link=STEMI resident survival guide]]|| <br> || <br>
  ICDO          = |
| [[STEMI resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
  OMIM          = |
|}
  MedlinePlus    = 000195 |
{{ST elevation myocardial infarction}}
  eMedicineSubj  = med |
  eMedicineTopic = 1567 |
  eMedicine_mult = {{eMedicine2|emerg|327}} {{eMedicine2|ped|2520}} |
  MeshID        = |
}}


'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[Heart attack (patient information)|here]]'''


{{SI}}
{{CMG}} {{AKK}}


__NOEDITSECTION__
{{SK}} AMI, STEMI, heart attack, MI, myocardial infarct, acute MI, coronary, coronary thrombosis
{{SI}}


{{WikiDoc Cardiology Network Infobox}}
== [[ST elevation myocardial infarction overview|Overview]] ==


{{CMG}}
== [[ST elevation myocardial infarction classification|Classification]] ==
[[Anterior myocardial infarction]] | [[Inferior myocardial infarction]] | [[Right ventricular myocardial infarction]] | [[Posterior myocardial infarction]] | [[Lateral myocardial infarction]]


In suggesting edits to the guidelines, WikiDoc suggests that the following classification scheme used by the ACC / AHA guidelines. [[ACC AHA Guidelines Classification Scheme|Read more about the classification scheme used by the ACC / AHA Guidelines Committee here]].
== [[ST elevation myocardial infarction pathophysiology|Pathophysiology]] ==
----
'''''Keywords and synonyms:''''' <small>AMI, STEMI, heart attack, MI, myocardial infarct, acute MI, coronary, coronary thrombosis </small>


==Overview==
[[ST elevation myocardial infarction pathophysiology|Pathophysiology of Vessel Occlusion]] | [[ST Elevation Myocardial Infarction: Pathophysiology of Reperfusion|Pathophysiology of Reperfusion]] |  [[ST elevation myocardial infarction gross pathology|Gross Pathology]] | [[ST elevation myocardial infarction histopathology|Histopathology]]


===[[ST Elevation Myocardial Infarction Overview|Overview]]===
== [[ST elevation myocardial infarction causes|Causes]] ==


===[[ST Elevation Myocardial Infarction: Epidemiology and Demographics | Epidemiology and Demographics]]===
== [[ST elevation myocardial infarction differential diagnosis|Differentiating ST Elevation Myocardial Infarction from other Diseases]] ==


== [[ST elevation myocardial infarction epidemiology and demographics|Epidemiology and Demographics]] ==


==Pathophysiology==
== [[ST elevation myocardial infarction risk factors|Risk Factors]] ==


===[[ST Elevation Myocardial Infarction Risk Factors|Risk Factors]]===
== [[ST elevation myocardial infarction triggers|Triggers]] ==


===[[ST Elevation Myocardial Infarction Triggers|Triggers]]===
== [[ST elevation myocardial infarction natural history and complications|Natural History and Complications]] ==


===[[ST Elevation Myocardial Infarction Pathophysiology|Pathophysiology of Vessel Occlusion]]===
==[[ST elevation myocardial infarction risk stratification and prognosis|Risk Stratification and Prognosis]]==


===[[ST Elevation Myocardial Infarction: Pathophysiology of Reperfusion |Pathophysiology of Reperfusion]]===
==[[ST elevation myocardial infarction in pregnancy|STEMI in Pregnancy]]==


== Diagnosis ==


==Diagnosis==
[[ST elevation myocardial infarction diagnostic criteria|Diagnostic Criteria]] | [[ST elevation myocardial infarction history and symptoms|History and Symptoms]] | [[ST elevation myocardial infarction physical examination|Physical Examination]] | [[ST elevation myocardial infarction laboratory findings|Laboratory Findings]] | [[ST elevation myocardial infarction electrocardiogram|Electrocardiogram]] | [[ST elevation myocardial infarction EKG examples|EKG Examples]] | [[ST elevation myocardial infarction chest x ray|Chest X Ray]] | [[ST elevation myocardial infarction cardiac MRI|Cardiac MRI]] | [[ST elevation myocardial infarction echocardiography|Echocardiography]] | [[ST elevation myocardial infarction coronary angiography|Coronary Angiography]]


===[[ST Elevation Myocardial Infarction Diagnosis|Diagnosis, classification and biomarkers]]===
== Treatment ==


===[[ST Elevation Myocardial Infarction Symptoms|Symptoms]]===
=== [[ST elevation myocardial infarction pre-hospital care|Pre-Hospital Care]] ===


===[[Chest pain|Differential diagnosis of chest pain]]===
=== [[ST elevation myocardial infarction initial care|Initial Care]] ===


===[[ST Elevation Myocardial Infarction Physical Examination|Physical Examination]]===
[[ST elevation myocardial infarction oxygen therapy|Oxygen]] | [[ST elevation myocardial infarction nitrate therapy|Nitrates]] | [[ST elevation myocardial infarction analgesic therapy|Analgesics]] | [[ST elevation myocardial infarction aspirin therapy|Aspirin]] | [[ST elevation myocardial infarction beta blocker therapy|Beta Blockers]] | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy|Antithrombins]] | [[Coronary care unit|The coronary care unit]] |  [[Step Down Unit|The step down unit]] | [[STEMI and Out-of-Hospital Cardiac Arrest]]


===[[ST Elevation Myocardial Infarction Electrocardiogram|Electrocardiogram]]===
'''Pharmacologic Reperfusion''' | [[ST elevation myocardial infarction reperfusion therapy|Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)]] | [[ST elevation myocardial infarction fibrinolytic therapy|Fibrinolysis]]


===[[ST Elevation Myocardial Infarction Coronary Angiography|Coronary Angiography]]===
'''Mechanical Reperfusion''' | [[Door-to-Balloon|The importance of reducing Door-to-Balloon times]] | [[ST elevation myocardial infarction primary percutaneous coronary intervention|Primary PCI]] | [[ST elevation myocardial infarction percutaneous coronary intervention following fibrinolytic administration|Adjunctive and Rescue PCI]] | [[ST elevation myocardial infarction rescue percutaneous coronary intervention|Rescue PCI]]  |
[[ST elevation myocardial infarction facilitated percutaneous coronary intervention|Facilitated PCI]] |
[[ST Elevation Myocardial Infarction Adjunctive Percutaneous Coronary Intervention|Adjunctive PCI]] |
[[ST elevation myocardial infarction coronary artery bypass grafting|CABG]] | [[ST elevation myocardial infarction management of patients who were not reperfused|Management of Patients Who Were Not Reperfused]] | [[ST elevation myocardial infarction assessing success of reperfusion|Assessing Success of Reperfusion]]


===[[ST Elevation Myocardial Infarction Gross Pathology|Gross Pathology]]===
'''Antithrombin Therapy''' | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy|Antithrombin therapy]] | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Unfractionated Heparin|Unfractionated heparin]]  | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Enoxaparin|Low Molecular Weight Heparinoid Therapy]] | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Bivalirudin|Direct Thrombin Inhibitor Therapy]] |  [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Fondaparinux|Factor Xa Inhibition]] | [[ST elevation myocardial infarction deep vein thrombosis prophylaxis and anticoagulation|DVT prophylaxis]] |  [[ST elevation myocardial infarction deep vein thrombosis prophylaxis and anticoagulation|Long term anticoagulation]]


===[[ST Elevation Myocardial Infarction Histopathology|Histopathology]]===
'''Antiplatelet Agents''' | [[ST elevation myocardial infarction aspirin therapy|Aspirin]] | [[ST elevation myocardial infarction thienopyridine therapy|Thienopyridine Therapy]] | [[ST elevation myocardial infarction glycoprotein IIbIIIa inhibition|Glycoprotein IIbIIIa Inhibition]]


==Treatment==
'''Other Initial Therapy'''  |  [[ST elevation myocardial infarction inhibition of the renin-angiotensin-aldosterone system at discharge|Inhibition of the Renin-Angiotensin-Aldosterone System]] | [[ST elevation myocardial infarction magnesium therapy|Magnesium Therapy]] |  [[ST elevation myocardial infarction glucose control|Glucose Control]] | [[ST elevation myocardial infarction calcium channel blocker therapy|Calcium Channel Blocker Therapy]] | [[ST elevation myocardial infarction lipid management|Lipid Management]]


===[[ST Elevation Myocardial Infarction Pre-Hospital Care|Pre-Hospital Care]]===
=== [[ST elevation myocardial infarction discharge care|Pre-Discharge Care]] ===


===[[ST Elevation Myocardial Infarction Initial Care|Initial Care]]===
==Long-Term Medical Therapy and Secondary Prevention ==
[[ST elevation myocardial infarction secondary prevention|Overview]] | [[ST elevation myocardial infarction inhibition of the renin-angiotensin-aldosterone system at discharge|Inhibition of the Renin-Angiotensin-Aldosterone System]]  |
[[ST elevation myocardial infarction cardiac rehabilitation|Cardiac Rehabilitation]] | [[ST elevation myocardial infarction pacemaker implantation|Pacemaker Implantation]] | [[ST elevation myocardial infarction deep vein thrombosis prophylaxis and anticoagulation|Long Term Anticoagulation]] | [[ST elevation myocardial infarction implantable cardioverter defibrillator|Implantable Cardioverter Defibrillator]]


[[ST Elevation Myocardial Infarction Oxygen Therapy|Oxygen]] | [[ST Elevation Myocardial Infarction Nitrate Therapy|Nitrates]] | [[ST Elevation Myocardial Infarction Analgesic Therapy|Analgesics]] | [[ST Elevation Myocardial Infarction Aspirin Therapy|Aspirin]] | [[ST Elevation Myocardial Infarction Beta Blocker Therapy|Beta Blockers]] | [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy|Antithrombins]] | [[Coronary care unit|The coronary care unit]] |  [[Step Down Unit|The step down unit]]
==Case Studies==
[[ST elevation myocardial infarction case study one|Case #1]] | [[ST elevation myocardial infarction case study two|Case #2]] | [[ST elevation myocardial infarction case study three|Case #3]] | [[ST elevation myocardial infarction case study four|Case #4]] | [[ST elevation myocardial infarction case study five|Case #5]]


'''Pharmacologic Reperfusion''' | [[ST Elevation Myocardial Infarction Reperfusion Therapy|Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)]] | [[ST Elevation Myocardial Infarction Fibrinolytic Therapy|Fibrinolysis]]
== Disclaimer ==


'''Mechanical Reperfusion''' | [[Door-to-Balloon| The importance of reducing Door-to-Balloon times]] | [[ST Elevation Myocardial Infarction Primary Percutaneous Coronary Intervention|Primary PCI]] | [[ST Elevation Myocardial Infarction Percutaneous Coronary Intervention Following Fibrinolytic Administration|Adjunctive and Rescue PCI]] | [[ST elevation myocardial infarction rescue percutaneous coronary intervention|Rescue PCI]]  | 
[[ST elevation myocardial infarction facilitated percutaneous coronary intervention|Facilitated PCI]] |
[[ST Elevation Myocardial Infarction Adjunctive Percutaneous Coronary Intervention|Adjunctive PCI]] |
[[ST Elevation Myocardial Infarction Coronary Artery Bypass Grafting|CABG]] | [[ST Elevation Myocardial Infarction Management of Patients Who Were Not Reperfused|Management of Patients Who Were Not Reperfused]] | [[ST Elevation Myocardial Infarction Assessing Success of Reperfusion|Assessing Success of Reperfusion]]
'''Antithrombin Therapy'''  • [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy|Antithrombin therapy]] • [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Unfractionated Heparin|Unfractionated heparin]]  • [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Enoxaparin| Low Molecular Weight Heparinoid Therapy]] • [[ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Bivalirudin| Direct Thrombin Inhibitor Therapy]] •  [[ ST elevation myocardial infarction anticoagulant and antithrombotic therapy#Fondaparinux|Factor Xa Inhibition]]
'''Antiplatelet Agents''' | [[ST Elevation Myocardial Infarction Aspirin Therapy|Aspirin]] | [[ST Elevation Myocardial Infarction Thienopyridine Therapy|Thienopyridine Therapy]] | [[ST Elevation Myocardial Infarction Glycoprotein IIbIIIa Inhibition|Glycoprotein IIbIIIa Inhibition]]
'''Other Initial Therapy'''  |  [[ST Elevation Myocardial Infarction Inhibition of the Renin-Angiotensin-Aldosterone System|Inhibition of the Renin-Angiotensin-Aldosterone System]] | [[ST Elevation Myocardial Infarction Magnesium Therapy|Magnesium Therapy]] |  [[ST Elevation Myocardial Infarction Glucose Control|Glucose Control]] | [[ST Elevation Myocardial Infarction Calcium Channel Blocker Therapy|Calcium Channel Blocker Therapy]]
==Discharge Care==
[[ST Elevation Myocardial Infarction Secondary Prevention|Secondary Prevention]] | [[ST Elevation Myocardial Infarction Inhibition of the Renin-Angiotensin-Aldosterone System at Discharge|Inhibition of the Renin-Angiotensin-Aldosterone System]]  | 
[[ST Elevation Myocardial Infarction Cardiac Rehabilitation|Cardiac Rehabilitation]] | [[ST Elevation Myocardial Infarction Prognosis|Prognosis]] | [[ST elevation myocardial infarction pacemaker implantation|Pacemaker Implantation]]
==Complications==
===[[ST Elevation Myocardial Infarction Complications|Overview]]===
'''Ischemic Complications:''' [[Reinfarction]]
'''Mechanical Complications:'''[[Cardiogenic shock]]  |  [[Left ventricular aneurysm]]  |  [[Myocardial rupture]]  |  [[Left ventricular aneurysm|Pseudoaneurysm]]  |  [[Papillary muscle rupture]]  | 
[[Rupture of the ventricular septum]]
'''Arrhythmic Complications:'''  [[Sudden cardiac death]]
'''Embolic Complications:'''  [[Stroke]]
'''Pericarditis:'''  [[Post myocardial infarction pericarditis]]  |  [[Dressler's syndrome]]
==See also==
* [[The Living Guidelines: STEMI]]
==Disclaimer==
Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the [[wikidoc:General disclaimer|disclaimers]] page for important information regarding limitations of the information found here.
Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the [[wikidoc:General disclaimer|disclaimers]] page for important information regarding limitations of the information found here.


==External links==
[[es:Infarto agudo de miocardio]]
 
[[fr:Infarctus du myocarde]]
* [http://www.themdtv.org The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research]
[[tr:Akut miyokard enfarktüsünün klinik sınıflaması]]
* [http://www.clinicaltrialresults.org Clinical Trial Results: An up to date resource of Cardiovascular Research]
* [http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study from the United States National Heart, Lung and Blood Institute]
* [http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Attack overview from MedlinePlus]
* [http://ww2.heartandstroke.ca/Page.asp?PageID=1975&ArticleID=5288 Heart Attack Warning Signals from the Heart and Stroke Foundation of Canada]
* [http://www.regionalpci-stemi.org/index.html A Regional PCI and Resource Center for STEMI]
* [http://www.stemisystems.org/ STEMI Systems' Quarterly newsletter]
* [http://d2b.acc.org/ American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.]
* [http://www.americanheart.org/heartattack American Heart Association's Heart Attack web site]  
 
{{STEMI}}
{{STEMI}}
{{Circulatory system pathology}}


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[[es:Infarto agudo de miocardio]]
[[eu:Miokardio infartu akutu]]
[[fr:Infarctus du myocarde]]
[[ko:심근경색]]
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Latest revision as of 00:15, 30 July 2020



Resident
Survival
Guide

Acute Coronary Syndrome Main Page

ST Elevation Myocardial Infarction Microchapters

Home

Patient Information

Overview

Pathophysiology

Pathophysiology of Vessel Occlusion
Pathophysiology of Reperfusion
Gross Pathology
Histopathology

Causes

Differentiating ST elevation myocardial infarction from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History and Complications

Risk Stratification and Prognosis

Pregnancy

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples

Chest X Ray

Cardiac MRI

Echocardiography

Coronary Angiography

Treatment

Pre-Hospital Care

Initial Care

Oxygen
Nitrates
Analgesics
Aspirin
Beta Blockers
Antithrombins
The coronary care unit
The step down unit
STEMI and Out-of-Hospital Cardiac Arrest
Pharmacologic Reperfusion
Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI)
Fibrinolysis
Reperfusion at a Non–PCI-Capable Hospital:Recommendations
Mechanical Reperfusion
The importance of reducing Door-to-Balloon times
Primary PCI
Adjunctive and Rescue PCI
Rescue PCI
Facilitated PCI
Adjunctive PCI
CABG
Management of Patients Who Were Not Reperfused
Assessing Success of Reperfusion
Antithrombin Therapy
Antithrombin therapy
Unfractionated heparin
Low Molecular Weight Heparinoid Therapy
Direct Thrombin Inhibitor Therapy
Factor Xa Inhibition
DVT prophylaxis
Long term anticoagulation
Antiplatelet Agents
Aspirin
Thienopyridine Therapy
Glycoprotein IIbIIIa Inhibition
Other Initial Therapy
Inhibition of the Renin-Angiotensin-Aldosterone System
Magnesium Therapy
Glucose Control
Calcium Channel Blocker Therapy
Lipid Management

Pre-Discharge Care

Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

Post Hospitalization Plan of Care

Long-Term Medical Therapy and Secondary Prevention

Overview
Inhibition of the Renin-Angiotensin-Aldosterone System
Cardiac Rehabilitation
Pacemaker Implantation
Long Term Anticoagulation
Implantable Cardioverter Defibrillator
ICD implantation within 40 days of myocardial infarction
ICD within 90 days of revascularization

Case Studies

Case #1

Case #2

Case #3

Case #4

Case #5

ST elevation myocardial infarction On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on ST elevation myocardial infarction

CDC on ST elevation myocardial infarction

ST elevation myocardial infarction in the news

Blogs on ST elevation myocardial infarction

Directions to Hospitals Treating ST elevation myocardial infarction

Risk calculators and risk factors for ST elevation myocardial infarction

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Arzu Kalayci, M.D. [2]

Synonyms and keywords: AMI, STEMI, heart attack, MI, myocardial infarct, acute MI, coronary, coronary thrombosis

Overview

Classification

Anterior myocardial infarction | Inferior myocardial infarction | Right ventricular myocardial infarction | Posterior myocardial infarction | Lateral myocardial infarction

Pathophysiology

Pathophysiology of Vessel Occlusion | Pathophysiology of Reperfusion | Gross Pathology | Histopathology

Causes

Differentiating ST Elevation Myocardial Infarction from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History and Complications

Risk Stratification and Prognosis

STEMI in Pregnancy

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | EKG Examples | Chest X Ray | Cardiac MRI | Echocardiography | Coronary Angiography

Treatment

Pre-Hospital Care

Initial Care

Oxygen | Nitrates | Analgesics | Aspirin | Beta Blockers | Antithrombins | The coronary care unit | The step down unit | STEMI and Out-of-Hospital Cardiac Arrest

Pharmacologic Reperfusion | Reperfusion Therapy (Overview of Fibrinolysis and Primary PCI) | Fibrinolysis

Mechanical Reperfusion | The importance of reducing Door-to-Balloon times | Primary PCI | Adjunctive and Rescue PCI | Rescue PCI | Facilitated PCI | Adjunctive PCI | CABG | Management of Patients Who Were Not Reperfused | Assessing Success of Reperfusion

Antithrombin Therapy | Antithrombin therapy | Unfractionated heparin | Low Molecular Weight Heparinoid Therapy | Direct Thrombin Inhibitor Therapy | Factor Xa Inhibition | DVT prophylaxis | Long term anticoagulation

Antiplatelet Agents | Aspirin | Thienopyridine Therapy | Glycoprotein IIbIIIa Inhibition

Other Initial Therapy | Inhibition of the Renin-Angiotensin-Aldosterone System | Magnesium Therapy | Glucose Control | Calcium Channel Blocker Therapy | Lipid Management

Pre-Discharge Care

Long-Term Medical Therapy and Secondary Prevention

Overview | Inhibition of the Renin-Angiotensin-Aldosterone System | Cardiac Rehabilitation | Pacemaker Implantation | Long Term Anticoagulation | Implantable Cardioverter Defibrillator

Case Studies

Case #1 | Case #2 | Case #3 | Case #4 | Case #5

Disclaimer

Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the disclaimers page for important information regarding limitations of the information found here.


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