Heart Attacks - STEMI vs. NSTEMI
Published On - November 01, 2021
Overview
A heart attack, or myocardial
infarction, is a medical emergency in which the supply of blood to the heart is
suddenly and severely reduced or cut off, causing the muscle to die from lack
of oxygen. More than 1.1 million people experience a heart attack (myocardial
infarction) each year, and for many of them, the heart attack is their first
symptom of coronary artery disease. A heart attack may be severe enough to
cause death or it may be silent. As many as one out of every five people have
only mild symptoms or none at all, and the heart attack may only be discovered
by routine electrocardiography done some time later.
Causes
and Risk Factors
A heart attack (myocardial
infarction) is usually caused by a blood clot that blocks an artery of the
heart. The artery has often already been narrowed by fatty deposits on its
walls. These deposits can tear or break open, reducing the flow of blood and releasing
substances that make the platelets of the blood sticky and more likely to form
clots. Sometimes a clot forms inside the heart itself, then breaks away and
gets stuck in an artery that feeds the heart. A spasm in one of these arteries
can cause the blood flow to stop.
Diagnosis
Because a heart attack
(myocardial infarction) can be life threatening, men older than 35 or women
older than 50 who have chest pain should be examined to see if they are having
a heart attack. However, similar pain can be caused by pneumonia, a blood clot
in the lung (pulmonary embolism), pericarditis, a rib fracture, spasm of the
esophagus, indigestion or chest muscle tenderness after injury or exertion. A
heart attack can be confirmed within a few hours of its occurrence by:
Electrocardiography (ECG)
Blood tests to measure levels of serum markers. The
presence of these markers shows that there has been damage to or death of the
heart muscle. These markers are normally found in the heart muscle, but they
are released into the blood when the heart muscle is damaged.
Echocardiography can be performed if the above
tests do not give enough information
Radionuclide imaging can also be done
Acute coronary syndrome and heart attacks
Acute coronary syndrome (ACS) is when the arteries that carry blood,
oxygen, and nutrients get blocked. Heart attacks are a form of ACS. They occur
when your heart doesn’t get enough blood supply. A heart attack is also known
as a myocardial infarction.
The three types of heart
attacks are:
- ST segment elevation myocardial infarction (STEMI)
- non-ST segment elevation myocardial infarction (NSTEMI)
- coronary spasm, or unstable angina
“ST segment” refers to the pattern that appears on an electrocardiogram,
which is a display of your heartbeat. Only a STEMI will show elevated segments.
Both STEMI and NSTEMI heart attacks can cause enough damage to be considered
major heart attacks.
Read on to learn more about each type of heart attack, as well as
information on prevention, treatment, and recovery.
STEMI: The classic or major heart attack
When most people think of a heart attack, they
often think of a STEMI. A STEMI occurs when a coronary artery becomes
completely blocked and a large portion of the muscle stops receiving blood.
It’s a serious heart attack that can cause significant damage.
Symptoms and signs of a STEMI
A STEMI has the classic symptom of pain in the center of the chest. This
chest discomfort may be described as a pressure or tightness rather than a
sharp pain. Some people who experience STEMIs also describe feeling pain in one
or both arms or their back, neck, or jaw.
Other symptoms that may accompany chest pain include:
- nausea
- shortness of breath
- anxiety
- lightheadedness
- breaking out in a cold sweat
NSTEMI heart attacks
Unlike in a STEMI, the affected coronary artery is
only partially blocked in a NSTEMI. A NSTEMI won’t show any change in the ST
segment on the electrocardiogram.
A coronary angiography will show the degree to which the artery is blocked. A
blood test will also show elevated troponin protein levels. While there may be
less heart damage, an NSTEMI is still a serious condition.
CAS, silent heart attack, or heart attack without blockage
The coronary artery spasm is also known as a
coronary spasm, unstable angina, or silent heart attack. The symptoms, which
can be the same as a STEMI heart attack, may be mistaken for muscle pain,
indigestion, and more. It occurs when one of the heart’s arteries tightens so
much that blood flow stops or becomes drastically reduced. Only imaging and
blood test results can tell your doctor if you’ve had a silent heart attack.
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