A STEMI is a type of heart attack. There are different options for treating a STEMI.

What is an ST elevation myocardial infarction?

The medical term for heart attack is myocardial infarction or MI. Some types of myocardial infarctions, or heart attacks, are caused by a partially blocked coronary artery. A heart attack with a completely blocked coronary artery is called a STEMI.

STEMI stands for ST Elevation Myocardial Infarction. On a heart tracing there is a particular area that is called the ST segment. When this segment is elevated, the person is said to have a STEMI. All STEMI patients in Fraser Health are transported to Royal Columbian Hospital for STEMI treatment.

Where would I receive treatment for a STEMI?

Treatment for STEMI in Fraser Health takes place at Royal Columbian Hospital, in our Cardiac Catheterization Laboratory, with special equipment and staff.

Once the procedure is complete, the patient usually returns to the hospital where he or she was transferred from. However, some patients may need to stay at Royal Columbian Hospital for further treatment. If the patient comes to Royal Columbian Hospital directly from home or somewhere in the community, they will be admitted to Royal Columbian Hospital. Sometimes, we will arrange transport of patients to a community hospital near where the patient lives.

How is a STEMI diagnosed?

A STEMI is diagnosed by heart tracing or electrocardiogram (ECG). If a person is having symptoms of a heart attack, an ECG is performed when a person first seeks medical help. If a person calls for an ambulance, the paramedics will usually perform this heart tracing and transmit it to Royal Columbian Hospital to be read by a doctor. If a person goes into the emergency room for medical help, then the electrocardiogram will be done when they arrive.

What are the treatment options for a STEMI?

There are four possibilities for treatment of a heart attack. Which treatment you receive will depend on the results of your tests, and will be discussed between you and your heart doctor or cardiologist.

  • Option 1: Percutaneous coronary intervention (PCI)

    First, we look for where the blockage is located. This procedure is called an angiogram. Then, in most cases, we open the blocked artery with a procedure called percutaneous coronary intervention (PCI), which is an angioplasty with a stent.

    A heart specialist called a cardiologist does these procedures. Once we locate the block, the next step is to open the blockage. Usually, we do this by inserting a small hollow balloon with a small metal tube called a stent. We open the stent at the site of the blockage. This allows blood to flow to the heart muscle.

  • Option 2: Thrombolysis

    Most often when a person has a heart attack, there is a blood clot blocking blood flow in the heart arteries. Sometimes, the doctor will recommend a special clot-busting drug to be given. This may be done in addition to percutaneous coronary intervention or may be instead of percutaneous coronary intervention.

    The clot-busting drug breaks up all clots in the body including the one that is blocking the heart artery. For this reason, patients are prone to bleeding. Your doctor will screen you carefully to determine if you can safely have this clot-busting drug.

  • Option 3: Medications

    Some people do not need to have a percutaneous coronary intervention or thrombolysis. Your doctor may suggest medications to help with any symptoms that you may have. If your doctor suggests this, he or she will work with you to find the right medications for you.

  • Option 4: Coronary bypass surgery

    Some patients who have a heart attack have several blocked arteries and require coronary bypass surgery. This usually occurs at a different time than the heart attack. Initially, the cardiologist will open the blocked artery that is causing the heart attack with percutaneous coronary intervention. Then the cardiologist will suggest coronary bypass surgery to treat the other blockages.

How long will I stay in hospital after a heart attack?

Patients generally remain in hospital two to five days after a heart attack. Your length of stay will depend on the severity of your heart attack, type of treatment you receive and any complications that you may have after the heart attack.