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Diagnosis and management of ST-elevation of myocardial infarction 

Diagnosis and management of ST-elevation of myocardial infarction
Chapter:
Diagnosis and management of ST-elevation of myocardial infarction
Author(s):

David Erlinge

and Göran Olivecrona

DOI:
10.1093/med/9780199600830.003.0147
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date: 01 August 2021

ST-elevation myocardial infarction (STEMI) is generally caused by a ruptured plaque that triggers local thrombus formation, which occludes the coronary artery. STEMI should be diagnosed rapidly, based on the combination of ST-segment elevation and symptoms of acute myocardial infarction. The main treatment objective is myocardial tissue reperfusion as quickly as possible. The preferred method of reperfusion is primary percutaneous coronary interventionif transport time is below 2 hours, and thrombolysis if longer STEMI patients with acute onset cardiogenic shock should be evaluated by echocardiography to exclude mechanical complications, such as flail mitral insufficiency, ventricular septal defect or tamponade. Secondary prevention includes aspirin, adenosine diphosphate receptor antagonists, statins, beta-blockers, angiotensin-converting enzymeinhibitors, and lifestyle changes.

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