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ST Elevation Myocardial Infarction (STEMI)

STEMI: The Most Severe Heart Attack

STEMI (ST Elevation Myocardial Infarction) is the most severe type of heart attack, causing extensive heart muscle damage and requiring immediate attention. At Baystate Medical Center, we treat over 300 patients with STEMI a year, more than anywhere else in Massachusetts.

 

Heart attacks fall into two categories, depending on severity. In any heart attack—also known as cardiac infarction (CI) or myocardial infarction (MI)—a coronary artery is at least partially or completely blocked or clogged by a blood clot. This causes that artery to become injured or die. With STEMI, the artery is completely blocked, causing the heart muscle being supplied by the artery to start dying in short amount of time. STEMI is diagnosed when a person has symptoms that are confirmed with an electrocardiogram (ECG) test.

 

If you suspect a heart attack, call 911 or your town's emergency services immediately.

 

Treatment: Fast is Vital

Successful treatment of STEMI requires speed—time is muscle. The Baystate team is trained at every level to quickly evaluate and intervene.

  

  • Emergency Medical Services: Our paramedics are the first line of response. They have a high success rate in recognizing STEMI through ECGs. The quicker the evaluation, the faster the treatment: providing oxygen, putting in an IV, giving aspirin and nitroglycerin.
  • The Emergency Department: When a possible STEMI is identified, paramedics contact the receiving emergency department. This system has helped decrease time-to-treatment by having the appropriate personnel available on arrival at the hospital.
  • Referral Hospitals: Baystate Medical Center services all of western Massachusetts. Our local partners, who recognize that the best mode of opening an occluded artery is by stents, refer all of their STEMIs to Baystate, improving care in their communities.
  • Baystate Medical Center: Baystate Medical Center continues to provide outstanding care to patients undergoing interventional cardiology (IC) procedures. Our mortality rates consistently remain lower than the national average. Baystate Medical Center consistently ranks among the top heart centers in the country.  In our time-to-treatment rates, we are recognized nationally for outcomes in heart attack care, including providing lifesaving angioplasty up to 25 minutes sooner than the national standard. In fact, Baystate is in the top 10% of hospitals nationwide in this critical statistic. We continue to work on treating our interventional cardiology patients within 90 minutes of arrival.

 

The Importance of Heart Testing Tools

ECG and other imaging techniques are used by interventional cardiologists to evaluate blood flow, pressure in the coronary arteries and chambers of the heart, and inflammation of the blood vessels of the heart. These tools are used when someone is having a heart attack, chest pain, chest tightness, or chest pressure.  The same tools are also used to monitor the treatment of heart conditions, such as post-heart attack, congenital heart defects, and repair of heart valve abnormalities.

 

These tools are necessary in diagnosing STEMIs, and they help differentiate other conditions such as broken heart syndrome. Broken heart syndrome is a temporary heart condition resulting from stress, such as a loved one’s death. A surge in stress hormones can temporarily enlarge one portion of the heart so that it doesn’t pump as well, while the rest remains normal. The result can be heart attack-like symptoms that last about a week, and are treatable. The condition was originally called takotsubo cardiomyopathy, and is now also referred to as apical ballooning syndrome, stress cardiomyopathy, or stress-induced cardiomyopathy.

 

The Most Experienced in MA

Baystate Medical Center in Springfield treats the largest volume of STEMIs in Massachusetts. We are the region’s tertiary care facility for interventional cardiology (IC) and have the second busiest IC lab in the state.  We perform approximately 1,300 coronary interventions here annually, and threat more than 300 STEMIs per year. 70% of our interventional procedures are urgent or emergent.

 

Critical to our program’s success is rapid assessment and access to primary percutaneous coronary intervention (PCI), a non-surgical procedure used to immediately unblock arteries.  We are the only hospital in the region with the capability to unblock an artery and stop a heart attack in its tracks, 24 hours a day/7 days a week.  We serve patients west to the New York border and east to Worcester, from the Connecticut border north to the Vermont border.

  

Baystate Medical Center has an active research program that has allowed us to be on the cutting edge of research with interventional cardiology, evaluating new drugs and new stents, and participating in stem cell research. More than 100 interventional cardiology clinical trials have led to better patient care and better outcomes.