NSTEMI

There are two types of heart attack, an ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI). An NSTEMI occurs if your artery is partially blocked and some blood flow continues. In this case, only part of your heart muscle may be damaged and the doctor will not see an ST elevation during an electrocardiogram (ECG) exam.

If you experience an NSTEMI, below is an example of the care you may receive.

  • When you call 9-1-1 with symptoms of a heart attack or go to your nearest emergency department to be evaluated by health-care professionals, you will be asked about your symptoms and undergo a physical examination, including an ECG, a chest x-ray and blood tests. If any heart cells have died, a protein will have been released into your blood. Often, if we find this protein in your blood, it confirms that you have had a heart attack. 
  • You will be referred to a cardiologist and likely admitted to the hospital. We will give you a drug called heparin and place you on a monitoring device. You will also be given other medication, including:
    • Aspirin to protect you from blood clots and lower your risk of another heart attack,
    • Antiplatelet medications to lower your risk of another heart attack,
    • Beta-blockers to lower the risk of abnormal heart rhythms, decrease the work of the heart and promote healing of heart muscle damage,
    • ACE inhibitors or angiotensin receptor blockers to promote healing of the heart and lower the risk of another heart attack,

    • Nitroglycerin to improve blood flow to the heart and treat chest pain, and

    • Statins to lower cholesterol and the risk of another heart attack.
  • You will be taken to the cardiovascular lab for an angiogram. This is a test that helps us determine where and by how much your arteries are blocked.
  • If significant blockages are found, you may need angioplasty and/or stenting. This means the narrowed portions of the arteries are propped open by small metal mesh tubes called stents. If the blockages are too difficult to fix you may be referred to a surgeon, who will assess you for surgery.
  • You will then be sent to an inpatient room to recover. Your length of stay may vary depending on your symptoms but generally, it should be between 3-5 days.

After discharge from the hospital

  • Continue to take your medication as prescribed by your doctor. This includes antiplatelet medication such as Aspirin, Clopidogrel (Plavix), Ticagrelor (Brilinta) or Prasugrel (Effient). Do not stop taking your medications unless directed by your health-care team. Note: Your stents require antiplatelet therapy as directed by your interventionalist.

  • Quickly seek medical assistance if you have any chest pain, jaw pain, arm heaviness or other symptoms similar to your previous heart attack.

  • You will receive a Cardiac Catheterization pamphlet from your health-care provider. Follow the instructions in the pamphlet closely.

  • Ask your doctor about how you can be referred to a cardiac rehabilitation program.

  • Avoid lifting anything heavy (greater than 10 lbs) in the first four weeks after your heart attack. Avoid activities such as heavy yard work.

  • You may resume sexual activity in 2-3 weeks.

For additional information on how to recover from a heart attack, the following links may be of interest: