What is the difference in the treatment between a STEMI and NSTEMI?
STEMI is ST elevation myocardial infarction and NSTEMI non ST elevation myocardial infarction. Myocardial infarction means damage to a region of the heart muscle due to reduction in blood supply or a supply that is not enough to meet its oxygen demand. Since STEMI is due to sudden thrombotic occlusion (formation of a blood clot) of a coronary artery (blood vessel carrying oxygenated blood to heart muscle), the mainstay of treatment is removal of the clot. This could be either by primary angioplasty (mechanical removal of the block ) or by thrombolytic therapy (treatment to dissolve the clot).
Primary angioplasty is the best option for STEMI, if the facility is locally available. Primary angioplasty is considered justified if the difference between the time required to arrange primary angioplasty is not more than 1 hour above the time for arranging thrombolysis.
NSTEMI is due to an unstable plaque with aggregation of platelets. Hence the mainstay of treatment is anti platelet drugs and anticoagulants. Aspirin, clopidogrel, beta blockers and statins are given to both types of infarction.