Management of STEMI

There have been numerous advancements in the management of ST-elevation myocardial infarcts (STEMI) for the last few decades. Studies have shown an improvement of survival of STEMI due to increased use of perfusion therapy and recommended medications. The success of timely reperfusion therapy for STEMI patients would require close collaboration between pre-hospital care, emergency medicine, and cardiology departments to address the processes and professional issues in the various stages of management. This article reviews the latest management methods and issues, both pharmacological as well as reperfusion strategies. The different phases of emergency care for STEMIs were examined and various strategies for achieving rapid diagnosis and to improve door-to-balloon or door-to-needle time were discussed. Reperfusion methods of percutaneous coronary interventions and fibrinolysis were reviewed. Current evidence on adjuvant pharmacological therapies such as anti-platelet, heparin, anti-thrombin inhibitors, nitrate, beta-blockers, and angiotensin-converting enzyme inhibitors were reviewed and examined.