STEMI

There are two types of heart attack, an ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI). A STEMI occurs when your artery is completely blocked and blood flow stops. In this case, the whole heart muscle might be damaged and your doctor will see an ST elevation during an electrocardiogram (ECG) exam. 

Kingston Health Sciences Centre (KHSC) is part of a regional program to ensure patients who have a STEMI receive the care they need when they need it. If you experience a STEMI, below is an example of the care you may receive. 

  • When you call 9-1-1 with symptoms of a heart attack, paramedics perform and interpret an electrocardiogram (ECG) exam upon their arrival. 
  • If the paramedics believe you are having a STEMI, you will be brought directly to KHSC's Kingston General Hospital (KGH) site. If you go to your local emergency department and you are diagnosed as having a STEMI, you will be brought immediately to the KGH site by ambulance. Patients in more distant parts of our region will be given clot-busting drugs (thrombolytics) and transported to the KGH site as fast as possible, sometimes by helicopter. 
  • You will be taken to the cardiovascular lab for an angiogram. This is a test that helps us determine where your arteries are blocked. Remember if you are diagnosed with a STEMI, the cause of the heart attack is a completely blocked artery.
  • The treatment is to open the blocked artery as quickly as possible in order to restore normal blood flow. You then may have angioplasty and/or stenting which 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.
  • Once your angiogram and perhaps angioplasty or stenting are complete, you will be transferred to an area where you can recover. Your length of stay in the hospital may be between two to four days.
  • You will also be given a number of medications, including:
    • Aspirin to lower your risk of another heart attack,
    • Blood thinners to lower your risk of another heart attack and prevent the blockage of any stent you may have received,
    • Beta-blockers to lower your risk of abnormal heart rhythms and promote healing of heart muscle damage,
    • ACE inhibitors or angiotensin receptor blockers to promote healing of your heart and lower the risk of another heart attack, and
    • Statins to lower your cholesterol and your risk of another heart attack.

After discharge from the hospital

When you are ready to be discharged from the hospital, your health-care teams will give you a number of instructions to follow when you get home. They are:

  • Continue to take your medication as prescribed by your doctor. This includes antiplatelet medication such as Aspirin, Plavix, Ticagrelor or Prasugrel. Do not stop taking your medications unless directed by your health-care team. 
  • 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.