Managing a Heart Attack: STEMI vs NSTEMI Protocols

Smoking in young patients, diabetes, hypertension, a family history of cardiac disease, a sedentary lifestyle, and lack of sleep are the major risk factors. Pollution and extremes of temperature can also precipitate an event.

During an acute coronary event, external defibrillation is used for life-threatening ventricular tachycardia or ventricular fibrillation, whether at presentation, during the procedure, or post-operatively. On longer-term follow-up, patients with poor heart function (a low ejection fraction) may need an ICD, a device similar to a pacemaker, implanted to protect against these arrhythmias.

Angioplasty is roughly 95 to 98% safe. The complications that can occur are access-site bleeding from the hand or groin, and rarer complications related to the coronary arteries themselves, such as stent thrombosis (a blocked stent) or, in difficult vessels, a perforation.

A heart attack patient left untreated has a 30 to 50% chance of dying; treated promptly with a procedure or thrombolysis, that risk falls to around 5%. Saving the largest number of lives in the smallest amount of time, across the globe, is the reason and the motivation.

Jivo's international team manages the entire process end to end, from the visa process to ambulance transfer at the airport, and makes sure family members travelling with the patient are comfortable too. They first take the patient's details and advise on the right course of action, so the point of contact should be the international team, who will coordinate directly with BLK-Max.

Immediately, based on ECG alone, without waiting for further tests: IV opioids, nitrates and oxygen, followed by PCI (stenting) as the gold standard, or thrombolytic therapy if PCI is not available.

Patients are stabilised on antiplatelet medication first; those who continue to have pain or are deteriorating go for early angiography (within two days), while lower-risk patients are managed medically before angiography.