Overview
STEMI is an acute myocardial infarction in which the ECG shows a characteristic persistent ST-segment elevation pattern in an appropriate clinical context.
Acute coronary occlusion is a common mechanism and requires urgent reperfusion-focused management.
Clinical Features
Patients commonly report prolonged central chest pressure with diaphoresis, nausea, dyspnea, or radiation to the arm or jaw.
ECG & Biomarkers
ECG is the key early investigation for identifying a STEMI pattern. Cardiac troponins confirm myocardial injury but should not unnecessarily delay urgent reperfusion decisions when the ECG and clinical picture are diagnostic.
Management
Immediate management includes stabilization, antithrombotic treatment when indicated, and urgent reperfusion therapy.
Primary PCI is the preferred reperfusion strategy when it can be delivered within the appropriate time frame.
Time to reperfusion matters because prolonged coronary occlusion increases irreversible myocardial injury.
Clinical Pearls
STEMI is a reperfusion emergency. ECG recognition should trigger rapid movement toward definitive reperfusion.
END OF REVIEW
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