Acute heart attack - Non-ST elevated myocardial infarct - NSTEMI

It is a lesion of the heart cells due to obstruction of one or more coronary arteries, resulting in a lack of oxygen to the myocardial cells.

 

There is a genetic predisposition associated with this disease. Factors favouring occlusion of the inner lumen of the coronary vessels have also been described: smoking, diabetes, hypercholesterolemia and hypertension.

 

It manifests with oppressive chest pain that may radiate to the arms, neck, shoulders and/or back. It is usually accompanied by sweating, nausea, vomiting, urge to defecate and a feeling of imminent death.

 

Diagnosis is clinical, by interrogation, physical examination and electrocardiogram. Rapid diagnosis is of vital importance to initiate treatment and save as many cardiac cells as possible.

 

Treatment aims to re-establish early blood circulation in the occluded cardiac vessel, using antiplatelet, anticoagulant and vasodilator drugs. Opioid analgesics will be used to relieve pain and heart rate slowing drugs to reduce the oxygen consumption of myocardial cells. If cardiac catheterisation is available, it is the best test to analyse the state of the arteries and to unblock them if possible.  In very severe cases, cardiac surgery may be necessary to place bypasses.