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Home » Cardiology » STEMI intervention: how to deal with severe ischaemic heart disease

Prof. Tom Kiernan

Consultant Interventional Cardiologist

Dr. Samer Arnous

Consultant Interventional Cardiologist and Cardiology Clinical Lead, ULHG

According to the Central Statistics Office 2022, 9,652 people died from cardiovascular disease in Ireland. Of these, 43% died from ischaemic heart disease — the most serious type is STEMI.

Ischaemic heart disease means that the heart is not getting enough blood and oxygen, usually caused by a narrowing of the coronary arteries. This narrowing can be caused by a blood clot or by a build-up of plaque (atherosclerosis).  

The most serious is an ST-elevation myocardial infarction (STEMI). A STEMI occurs when one of the coronary arteries becomes completely blocked. This is a life-threatening condition and requires immediate emergency treatment.  

Treatment services for STEMI 

The current gold standard of treatment for STEMI is primary percutaneous coronary intervention (PPCI). This emergency procedure opens up the coronary artery and restores blood flow to the heart muscle. In January 2013, UL Hospitals Group (ULHG) was chosen as one of five 24/7 PPCI centres to provide this service.  

Spearheaded by Professor Tom Kiernan we, at ULHG began accepting patients diagnosed with STEMI directly from our paramedic colleagues. We cover the geographical region of Limerick, Clare, Tipperary and North Kerry. We are the youngest of the five PPCI centres but our research has shown that we have decreased mortality from STEMI, improved outcomes for patients and decreased length of hospital stay.  

Patients at ULHG have timely access to many nurse specialists, such as in cardiac rehabilitation and heart failure, who see patients in outpatient clinics and take steps to improve long-term outcomes after STEMI. 

Although the chest pain is often severe,
some people may only experience mild pain.

Reducing risk of developing ischaemic heart disease 

Some risk factors can’t be changed, such as age, gender and family history.  

However, the following risk factors can be managed to reduce the risk of developing coronary artery disease: stopping smoking; regular blood pressure checks; normal cholesterol; healthy diet; regular moderate-intensity physical exercise; maintaining a healthy weight; and managing stress. 

Common signs and symptoms of a heart attack 

  • Chest pain: sensation of pressure, tightness or squeezing in the centre of your chest; it can sometimes travel to the arms, jaw, neck or back 
  • Feeling lightheaded or dizzy 
  • Sweating 
  • Shortness of breath 
  • Feeling sick or vomiting 

Although the chest pain is often severe, some people may only experience mild pain. In some cases, there may be no pain at all.  

If you suspect you may be having a heart attack 

Immediately dial 999/112 and ask for an ambulance. A heart attack is a medical emergency. 

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