University of California, Santa Cruz, CA.
Igbinedion University, Okada, Nigeria.
Medicine (Baltimore). 2023 Oct 27;102(43):e35687. doi: 10.1097/MD.0000000000035687.
ST-Segment Elevation Myocardial Infarction (STEMI) is a life-threatening medical emergency characterized by complete coronary artery occlusion, leading to myocardial ischemia and subsequent necrosis. Over the years, STEMI has remained a significant cause of morbidity and mortality worldwide, necessitating a comprehensive understanding of its pathophysiology, accurate diagnostic strategies, and effective treatment approaches. This review article aims to thoroughly analyze the current knowledge surrounding STEMI, emphasizing key aspects crucial for optimizing patient outcomes. Firstly, the pathophysiology of STEMI will be explored, elucidating the sequence of events from coronary artery plaque rupture to thrombus formation and occlusion. This section will also cover the underlying risk factors contributing to STEMI development, including atherosclerosis, hypertension, and diabetes. Secondly, the diagnostic modalities for STEMI will be critically evaluated. Traditional electrocardiography remains the cornerstone of STEMI diagnosis. Still, advancements in imaging techniques such as cardiac magnetic resonance imaging and coronary angiography have enhanced accuracy and allow for better risk stratification. Furthermore, the review will delve into the latest treatment approaches for STEMI. Prompt reperfusion therapy through primary percutaneous coronary intervention or thrombolytic therapy is essential in restoring blood flow and salvaging the jeopardized myocardium. The role of adjunctive medical treatment, including antiplatelet agents, beta-blockers, and statins, will also be discussed in post-STEMI management.
ST 段抬高型心肌梗死(STEMI)是一种危及生命的医学急症,其特征为冠状动脉完全闭塞,导致心肌缺血和随后的坏死。多年来,STEMI 一直是全球发病率和死亡率的重要原因,需要全面了解其病理生理学、准确的诊断策略和有效的治疗方法。本文旨在全面分析 STEMI 的现有知识,强调优化患者结局的关键方面。首先,将探讨 STEMI 的病理生理学,阐明从冠状动脉斑块破裂到血栓形成和闭塞的一系列事件。这一部分还将涵盖导致 STEMI 发展的潜在危险因素,包括动脉粥样硬化、高血压和糖尿病。其次,将批判性地评估 STEMI 的诊断方式。传统心电图仍然是 STEMI 诊断的基石。然而,心脏磁共振成像和冠状动脉造影等成像技术的进步提高了准确性,并允许更好的风险分层。此外,本文还将探讨 STEMI 的最新治疗方法。通过直接经皮冠状动脉介入治疗或溶栓治疗进行及时再灌注治疗对于恢复血流和挽救濒死心肌至关重要。在 STEMI 后管理中,还将讨论辅助药物治疗(如抗血小板药物、β受体阻滞剂和他汀类药物)的作用。