🫀 STEMI: Diagnosis and Nursing

* * STEMI (ST-Elevation Myocardial Infarction) * *

Is complete acute coronary artery embolism (100%).

📌 * * Time is Muscle → The faster the blood vessels open, the lower the heart muscle death * *

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📍 1.Diagnosis with EKG (Gold Standard)

* * ST-segment elevation must be found in contiguous leads ≥ 2 leads * *

* * Criteria: * *

* ST elevation ≥ 1 mm (leads common)

* V2-V3:

* Male < 40 years old ± 2.5 mm

* Male ± 40 years old ± 2.0 mm

* Female ≥ 1.5 mm

* * Supporting: * *

* * * Reciprocal ST depression * * in leads Opposite → Help confirm STEMI

* * Remember position: * *

* Septal: V1-V2 → LAD

* Anterior: V3-V4 → LAD

* Lateral: I, aVL, V5-V6 → LCX / LAD

* Inferior: II, III, aVF → RCA (beware RV infarct)

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💊 2. Initial treatment (Emergency Management)

🎯 Target: * * Fastest Reperfusion * *

* * Initial treatment (MONA): * *

* Morphine → Reduce pain + anxiety

* Oxygen → when O ☁ sat < 90%

* Nitroglycerin → Reduce preload / dilate blood vessels

* Aspirin → Instant chew 160-325 mg

* * Definitive treatment: * *

* Primary PCI → Door-to-balloon < 90 min

* Fibrinolytic → Door-to-needle < 30 minutes (if PCI can't catch up)

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⚠️ 3. Absolute Contraindications

❌ There is one = forbid immediately.

1. Used to have intracranial hemorrhage

2.Ischemic stroke within 3 months

3. Suspected aortic dissection

4. With active internal bleeding

5.Brain tumor / head injury. Severe in 3 months.

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# # 👩‍⚕️ 4.Nursing Care

* * 1.Monitoring * *

* Continuous EKG

* Surveillance lethal arrhythmia (VT / VF)

* * 2.Assessment * *

* Assess pain (chest paint)

* Evaluate heart failure (lung sound, O ❣ sat)

* * 3.After medication / Operation * *

* Surveillance bleeding

* Assess neurological status (GCS)

* * 4.evaluate reperfusion * *

* ST decrease > 50% within 60-90 minutes

* Chest pain improves

* Reperfusion arrhythmia may be found.

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# # 📌 Short summary

👉 * * "Sensitive diagnosis, quick opening of blood vessels, surveillance of arrhythmia and bleeding" * *

# STEMI

# Heart disease

# Heart ischemia

# EKG

# ECG

# Emergency

# Nurse addicted to series