About 600 per million of the population will have ST elevation myocardial infarction (STEMI), ie a big heart attack. This should be treated with immediate transfer to a Heart Attack Centre (HAC) that can provide immediate coronary angioplasty. This should be done as soon as possible after the onset of pain.
Treatments recommended are:
-Use the radial, or wrist, route over the femoral, or leg, route -Use clot extraction devices to reduce clot burden -Offer primary angioplasty in shocked patients presenting within 12 hours -After cardiac arrest, offer primary angioplasty even if conscious level has not fully recovered
London is lucky to have 8 NHS HACs. Dr Malik runs the one at Hammersmith Hospital.
After recovery it is vital to be on the correct medication and have cardiac rehabilitation. This will present the next heart attack!