Discussion : STEMI Heart Attack Essay

Discussion : STEMI Heart Attack Essay

Discussion : STEMI Heart Attack Essay

The coronavirus disease 2019 (COVID-19) pandemic has emerged as a major global public health emergency ^[1]. Many countries, including the Republic of Ireland, have instituted restrictions on their citizens in order to reduce the transmission of the virus ^[2], [3], colloquially referred to as ‘lockdown’. Concern has been raised regarding an observed decrease in the number of ST elevation myocardial infarction (STEMI) presentations during this period ^[4], [5]. Numerous theories have been proposed regarding this phenomenon ^[4]. The most concerning hypothesis is that patients with symptoms of acute myocardial ischemia may not be presenting to medical attention due to lockdown measures or concern regarding COVID-19.

The Republic of Ireland has a population of approximately 4.9 million ^[6] with over 1,100 primary percutaneous coronary intervention (PPCI) procedures performed annually ^[7]. Based on the latest published data, our center performs the third highest number of PPCI procedures and has the highest rate of ‘timely’ PPCI in the Republic of Ireland as defined by a first medical contact to balloon time of less than 120 min ^[7].

With this in mind, we analyzed the data for STEMI presentations at our center during the COVID-19 lockdown in order to determine any changes in the pattern of presentation compared to the same period in 2019. We have previously published data demonstrating an absence of seasonal or monthly variation in the pattern of STEMI presentations at our centre ^[8]. Therefore, any variation in the pattern of STEMI presentation was felt to likely be secondary to the current COVID-19 pandemic and resultant lockdown measures.

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A STEMI is a classic heart attack which happens on complete blockage of the coronary artery, preventing blood supply to a huge portion of the heart muscles. The classical symptom of a STEMI is crushing pain at the center of the chest which may radiate to the jaw, the neck or left arm, accompanied by shortness of breath, dizziness, anxiety, and restlessness (Dalal et al., 2014). Also known as an ST-segment elevation myocardial infarction, its diagnosis can be confirmed via an EKG which is essential for all patients at high risk.  The management of a STEMI is by administering aspirin followed by immediate revascularization. Clinical evidence suggests that the earlier a patient undergoes revascularization, the higher the chances of good health outcomes. When immediately identified on EKG and a STEMI protocol implemented, a patient can undergo catheterization for possible stenting or an emergency PTCA on time (Dalal et al., 2014).

Reference

Dalal, J. J., Alexander, T., Banerjee, P. S., Dayasagar, V., Iyengar, S. S., Kerkar, P. G., & Mullasari, A. (2014). 2013 consensus statement for early reperfusion and pharmaco-invasive approach in patients presenting with chest pain diagnosed as STEMI (ST-elevation myocardial infarction) in an Indian setting. Journal of the Association of Physicians of India, 62, 13. STEMI heart attack essay

Please write 1 paragraph for each of the following (total 3 paragraphs) and each paragraph shall be no less than 3 sentences and no more than 6 sentences.

Please provide proper citation with page numbers of the material you are referencing.

1. Discuss one of the following: STEMI, Non-STEMI; congestive heart failure; murmurs; ventricular tachycardia; asystole
2. What is a safe treatment plan for a patient with Atrial Fibrillation?
3. What is a safe treatment plan to reduce a patient’s bilateral lower extremities pitting edema? .