Short for non-ST segment elevation myocardial infarction, an NSTEMI is a type of heart attack that results from coronary artery disease. It is not the most severe type of heart attack that a person can suffer from, but it is still one that should be treated as an emergency because it can cause permanent damage to the heart’s muscle tissue.
Understanding NSTEMI
NSTEMI is one of the three main categories of heart attacks that occur in people who have coronary artery disease. It is a description of what actually happens in the coronary arteries, because heart attacks are generally labeled depending on the severity of the blockage and the potential damage they can cause.
There is a cardiac test called an electrocardiogram, which renders a chart-like image of the heart's electrical signals. A trained cardiologist who reads the EKG results can immediately tell if a person has a STEMI or an NSTEMI. What this basically means is that each heart attack will show different waves on the EKG.
Along with unstable angina, both of the aforementioned types of heart attacks are acute coronary syndromes, which are the overall terms used to describe partial or complete blockage of one of your coronary arteries, which ends up depriving the heart of its blood supply.
Symptoms and causes of NSTEMI
All heart attacks generally have the same symptoms — unless you’re experiencing a silent heart attack, in which case you don’t have any physical signs that indicate a potential heart problem. Much like in the case of STEMIs, NSTEMIs can lead to:
- Chest pain
- Shortness of breath
- Nausea and vomiting
- Dizziness and lightheadedness
- Excessive sweating
- Extreme fatigue
Once again, like all type of heart attacks, NSTEMIs have pretty much the same causes and risk factors. Risk factors include high cholesterol levels, diabetes, hypertension, smoking, a sedentary lifestyle, being overweight, and a family history of heart attacks.
How is NSTEMI diagnosed?
When these markers are seen in the results, it’s generally because there has been some damage to the heart cells. However, this level of damage is way lower compared to what is seen in the blood test results of people who suffered a STEMI.
It’s important to note that by simply performing a blood test, doctors don’t have enough evidence to diagnose you with a heart attack. However, the wave patterns of the EKG of a person who suffered an NSTEMI are pretty clear. What’s more, the EKG can determine with better precision the type of heart attack you suffered.
An EKG, or electrocardiogram, is a machine that attaches to your body to record electrical impulses of your heart. The technician or doctor will place a number of patches on your chest, arms, and legs, while you lie still on a table.
In just a few minutes of rest, the EKG machine will render the results of your heartbeats, in the form of waves. A cardiologist will interpret the results, as they know exactly what the patterns indicate, and can better assess your heart status.
What treatment do you need when you have an NSTEMI?
Because NSTEMI is considered a mild heart attack, it’s often treated similarly to unstable angina rather than as you would treat STEMI. People who end up suffering this form of heart attack will require immediate attention, which implies that doctors will prioritize stabilizing the heart and making sure that no further damage occurs.
This means two things:
- It’s important to prevent cell death, which is caused by the heart not receiving enough blood. Patients will receive medication such as beta blockers and statins. These drugs are absorbed by the body and will start alleviating cardiac ischemia really quickly. People who are in pain may also receive morphine.
- The next step is stopping blood clot formations, which also relies on medication such as aspirin. Unlike in the case of STEMI, you will not be given clot busters.
Once a patient is stabilized, the doctor will determine if a more aggressive intervention is needed to treat the condition. This is usually done after specialists have analyzed the patient's outcome.
During the whole process of planning treatment, doctors will determine a thrombosis in myocardial infarction (TIMI) score. This score takes into consideration risk factors such as age, the number of angina episodes within the last day, the use of aspirin over the past week, number of coronary artery disease risk factors, and other such information.
If the TIMI score is between zero and two, it’s quite unlikely that doctors will choose to perform an intervention. If a person who suffered NSTEMI has at least three risk factors, it’s very likely that they will choose to perform an angioplasty and place a permanent stent in the narrow artery, to keep it open at all times.