Understanding Lateral STEMI

Introduction

A Lateral STEMI (ST-Elevation Myocardial Infarction) is a serious type of heart attack that affects the lateral (side) wall of the left ventricle of the heart. This is caused by a complete or near-complete blockage of blood flow in the left circumflex artery (LCX) or its branches, leading to significant heart muscle damage.

Causes of Lateral STEMI

The primary cause of a lateral STEMI is coronary artery disease (CAD) , which results from the buildup of plaque (atherosclerosis) in the arteries. Other factors include: - Hypertension (High Blood Pressure) - Smoking - High Cholesterol - Diabetes - Obesity - Sedentary Lifestyle - Family History of Heart Disease

ECG Diagnosis of Lateral STEMI

A 12-lead Electrocardiogram (ECG) is essential for diagnosing lateral STEMI. It shows characteristic ST-segment elevation in leads: - I, aVL (High lateral wall) - V5, V6 (Low lateral wall)

Symptoms of Lateral STEMI

Patients with lateral STEMI present symptoms such as: - Severe chest pain (crushing or squeezing, lasting more than 20 minutes) - Pain radiating to the left arm, shoulder, neck, or jaw - Shortness of breath - Sweating (diaphoresis) - Nausea and vomiting - Lightheadedness or fainting

Immediate Treatment

Lateral STEMI is a medical emergency requiring rapid intervention. Standard treatments include: 1. Emergency reperfusion therapy to restore blood flow: - Primary Percutaneous Coronary Intervention (PCI) (preferred) - Thrombolytic therapy in cases where PCI is unavailable 2. Medications: - Aspirin and P2Y12 inhibitors (clopidogrel, ticagrelor) (to prevent further clot formation) - Heparin or enoxaparin (anticoagulant) - Beta-blockers (to reduce heart workload) - Nitroglycerin (for symptom relief) - Statins (to lower cholesterol and stabilize plaque)

Long-Term Management & Prevention

After surviving a lateral STEMI, patients must adopt lifestyle changes and adhere to medical therapy to prevent recurrence: - Strict adherence to prescribed medications - Regular physical activity (as recommended by a cardiologist) - Healthy diet (Mediterranean diet preferred) - Smoking cessation - Blood pressure and blood sugar control - Regular follow-up with a cardiologist

Conclusion

Lateral STEMI is a life-threatening condition that requires early recognition and urgent medical intervention. Timely treatment significantly improves survival and reduces complications. If you or someone experiences symptoms of a heart attack, call emergency services immediately.

Source recommendations

1. American Heart Association Guidelines for STEMI Management

  1. https://www.ahajournals.org/doi/10.1161/01.cir.0000134791.68010.fa
  2. https://www.heart.org/en/professional/quality-improvement/mission-lifeline/mission-lifeline-hospital-stemi-and-nstemi-recognition
  3. https://professional.heart.org/en/science-news/2021-acc-aha-scai-guideline-for-coronary-artery-revascularization
  4. https://www.ahajournals.org/doi/10.1161/cir.0b013e3182742cf6
  5. https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack

2. European Society of Cardiology Guidelines for Acute Coronary Syndromes

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
  2. https://academic.oup.com/eurheartj/article/44/38/3720/7243210
  3. https://pubmed.ncbi.nlm.nih.gov/37622654/
  4. https://academic.oup.com/eurheartj/article/42/14/1289/5898842
  5. https://pubmed.ncbi.nlm.nih.gov/32860058/

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