Time Is Important
With a STEMI event, the sooner the patient is seen and treated, the greater the likelihood of a good outcome. That’s the whole reason why today heart attacks are treated at local and community hospitals. No longer do local emergency departments have to send patients to a university hospital or major medical center for treatment. Saving a half-hour or a couple of hours can make a huge difference for the patient.
Standards established by the Medical Board of the State of New Jersey recommend a 6-hour treatment window from the onset of symptoms. However, we have learned that there is value in treating a heart attack up to 12 hours after the onset of symptoms if the patient is still having active symptoms.
We want to treat all patients as quickly as possible, and patients should seek care, even if they believe that they’ve experienced symptoms for more than 6 or 12 hours. The quicker we start treatment, the more heart muscle is salvaged, and the more heart muscle that is kept alive, the better the heart muscle will perform.
Outlook for Patients After STEMI
Once a patient reaches the catheterization laboratory, our ability to open the blocked vessel is nearly 100%. Unfortunately, the national mortality statistics for a STEMI event remain high because of two factors: significant complications after the procedure and inability of patients to receive treatment early. It is estimated that 50% of STEMI-related fatalities occur because the patient was unable to receive treatment promptly.
If an artery has been blocked for more than an hour, the cells in the heart muscle that are no longer receiving oxygen start to rupture and die. Once normal blood flow resumes, irritation of the heart muscle can result in transient problems with heart rhythm, some of which may require shocking to reestablish a normal rhythm. We are well equipped to manage these issues to help the heart return to its normal function, but arrhythmia after STEMI is uncommon.
Patients who have had a STEMI are at increased risk for repeated heart attacks, heart arrhythmias, heart failure, and stroke. In addition, many patients experience anxiety and depression after STEMI.
Release From the Hospital
Typically, within two hours of completing the procedure, the patient can sit in a chair. We try to have patients back home within 72 hours and sometimes as early as 48 hours after a STEMI event.
Depending on a variety of factors, after an uncomplicated STEMI event, with only a single coronary artery affected, patients are typically home within two to three days. Before the patient is discharged, we ensure that the performance of the heart muscle has returned to normal, a follow-up ultrasound shows no other issues, and the patient is tolerating medications without any problems with heart rhythm or symptoms of heart failure.