ST-segment Elevation Myocardial Infarction (STEMI) is a condition in which the coronary artery is completely clogged. As a result, the heart muscle, which is receiving blood, develops acute blood deficiency which will occur within minutes or up to hours. The pathogenesis is mainly due to rupture of fat plaque in the Heart artery. When there is a rupture, the body will Call platelets and create blood clots to fill the lesion until they are completely clogged. The patient tends to have tight chest pain or fainting. Some may even have an acute cardiac arrest. This condition is an emergency with life-threatening. The mortality rate of this disease is 5-10 percent. Treatment is to open the clogged artery as soon as possible. “Because every minute lost means a permanent death of heart muscle, followed by ischemia.”
The Heart Center, Bangkok Hospital Phuket has developed the guidelines and care for this disease by referring to the international guidelines for foreign countries since 2017, so that the patients can receive effective and timely treatment. There are 2 methods to open blood vessels which are as follows:
- Medical treatment to disintegrate blood clot (Fibrinolytics)
- Cardiac catheterization and Angioplasty to open blood vessels with a balloon or stent (Percutaneous Coronary Intervention, PCI)
Nowadays the opening of the arteries by cardiac catheterization is the most effective method. The success rate in opening blood vessels is 95 percent compared to Fibrinolytic at 60-70 percent. Therefore, the Heart Center, Bangkok Hospital Phuket chose the cardiac catheterization to be the first treatment.
The physicians and staff must work against time to open the vessels as quickly as possible. According to the international standards, patients should undergo PCI procedure within 24 hours since the onset of symptoms and within 90 minutes of seeing a medical staff.
The Heart Center, Bangkok Hospital Phuket provides the standardized cardiac catheterization unit. The medical team of the Heart Center is ready 24 hours a day, providing rapid diagnostic and an efficient patient reception system making the possibility to open the blood vessels within 90 minutes.
In 2018, for the patients with ST-segment Elevation Myocardial Infarction (STEMI) at Bangkok Hospital Phuket, the rate of the cardiac vessel opening within 90 minutes since the patient met the medical staff was at 89 percent, which is 14 percent increased from 2017. It is a great statistic compared to the treatment results of the hospital in the United States, ranked at 50 percentile, which had the same rate at 85.1 percent.
*Source: ACC-NCDR Registry. Percentage of STEMI patients receiving Primary PCI with In 90 minutes. A Data Form The NCDR Chest Pain-MI Registry. J Am Coll Cardiol [Internet]. 2018 [cited 2019 Apr 12]. Available from: https://cvquality.acc.org/NCDR-Home/registries/hospital-registries/chest-pain-mi-registry