Let's learn about the most serious type of heart attack? (STEMI Heart Attack)

We've all heard the word "heart attack" a lot, haven't we? Maybe one of our family members or a friend has had one. But did you know that there are different types of heart attacks? Today we're going to talk about a type that is a little more serious and requires immediate treatment. Doctors call this STEMI. Don't worry, let's talk about this simply.

Why is it called STEMI? What does it mean?

Simply put, a heart attack is when an artery supplying blood to the heart suddenly becomes blocked, cutting off blood flow to the heart muscle. In medical terms, this is called ``Myocardial Infarction''.

Now let's see how the name STEMI comes about. You've probably seen an ECG taken at a hospital. That's a test that checks the electrical activity of the heart. In this, the heartbeat is shown as a line graph. It's like a wavy line, like a hill or a slope.

There is a special part of this ECG, called the ``ST-segment''. In a healthy person, this part is normally flat. However, when a major artery supplying blood to the heart is completely blocked, that is, when a serious heart attack occurs, this ST segment rises up. Like a little hill.

This ECG change is a very important sign for doctors, because it means that a large part of the heart is not getting enough blood, and that part of the heart is dying. This means that treatment must be started immediately, without delaying even a minute .

How does a STEMI occur? What happens inside the body?

Most of the time, this is caused by plaque, a buildup of fat and cholesterol inside the blood vessels of the heart (coronary arteries). Think of it like rust forming inside a water pipe.

These plaques gradually get bigger. One day, one of these plaques can suddenly burst. Then our body thinks there is an injury there. So it makes a blood clot to heal that injury. But this blood clot suddenly gets bigger and completely blocks that vein.

That's when the real problem begins.

1. When the artery is completely blocked, the heart muscle cells that receive blood from it are deprived of oxygen. We call this condition `(ischemia)`.

2. Without oxygen, these pieces of meat slowly begin to die.

3. If a large part of the heart fails in this way, the heart cannot pump enough blood to the body. This can lead to a fatal condition called ``cardiogenic shock``.

4. Also, damaged heart muscle can disrupt the heart's electrical activity, causing the heart to suddenly stop beating (cardiac arrest).

STEMI is usually a more serious heart attack. That's why it's important to go to the hospital as soon as symptoms start. If you can quickly open the blocked artery and restore blood flow, you can greatly reduce the damage to the heart.

What is the difference between STEMI and NSTEMI?

You may have also heard of NSTEMI. There are some key differences between the two.

Who is most at risk of developing this?

The risk factors for having a heart attack can be divided into two categories: those we can control and those we cannot.

What are the symptoms that can be identified?

The symptoms of a heart attack are not the same for everyone, but the most common symptoms are:

• Chest pain or discomfort: This is the main symptom. It can feel like a tight, heavy, or constricting sensation in the middle of the chest. This pain may last for more than a few minutes.
• Pain spreading to other areas: Chest pain can spread to the left arm, both arms, shoulders, neck, jaw, back, or upper abdomen.
• Difficulty breathing: You may feel short of breath, with or without chest pain.
• Sweating: You may suddenly feel cold and start sweating.
• Nausea and vomiting: It can feel like an upset stomach, like gastritis.
• Dizziness and fainting: Feeling dizzy and unable to stand.
• Feeling great fear: You may feel great fear, even fear of death, for no reason.

Characteristics specific to women

Women may sometimes not feel the usual chest pain as severe. Instead, they may experience symptoms like these.

• Unusual tiredness: Feeling extremely tired for several days.
• Insomnia.
• Difficulty breathing.
• Pain in the back, shoulders, and jaw.
• Nausea and vomiting.

What kind of treatment is done at the hospital?

In a STEMI, time is of the essence in saving lives, so treatment is very rapid.

1. Immediate diagnosis: As soon as you are brought to the ETU, an ECG is taken to confirm whether it is STEMI.

2. Blood clot-dissolving medication: In some hospitals, an injection (thrombolysis) is given to dissolve the trapped blood clot.

3. Angioplasty and stent placement (PCI): This is the best and most modern treatment for STEMI. In this, a very thin tube is inserted through a vein in the arm or leg into the heart to the blocked artery. Then, a small balloon at the end of the tube is inflated to open the blocked artery, and a mesh-like device called a ``stent`` is placed in that place to prevent it from getting blocked again. This is called ``(Percutaneous Coronary Intervention - PCI)``.

4. Bypass surgery (CABG Surgery): If multiple blood vessels are blocked or PCI is not possible, surgery is performed to create new blood vessels. This is like building a new 'flyover' to bypass the blocked road.

5. Other medications: In addition to these treatments, several medications such as blood thinners (such as aspirin), cholesterol-lowering drugs (statins), and heart rate-controlling drugs (beta-blockers) will need to be taken for life.

What should I do if there is an emergency? Do I call 1990? Or do I go in a car?

This is a very important question. If you suspect that you or someone close to you is having symptoms of a heart attack, never drive yourself to the hospital. Never ask someone else to drive you.

The best thing to do is to call an ambulance service immediately, like 1990.

why is that?

• The officers on the ambulance are specially trained for these types of emergencies. They can begin providing basic treatment (such as oxygen) while you are being taken to the hospital.
• They can inform the hospital's ETU in advance and provide details about the patient. Then, when you arrive, the doctors and nurses will be ready to treat you. That saves valuable time.
• If an emergency occurs, such as a cardiac arrest, the ambulance has the necessary equipment (such as a defibrillator) to treat it. You can't do that in a home vehicle.