In-hospital cardiac arrest after STEMI: prevention strategies and post-arrest care

Abstract

Introduction: In-Hospital Cardiac Arrest (IHCA) after ST-segment Elevation Myocardial Infarction (STEMI) is a subset of IHCA with high morbidity. While information on this selected group of patients is limited, closer inspection reveals that this is a challenging patient population with certain risk factors for IHCA following treatment of STEMI.

Areas covered: In this review article, strategies for prevention of IHCA post STEMI are reviewed, as well as best-practices for the care of STEMI patients post-IHCA.

Expert opinion: Early and successful reperfusion is key for the prevention of IHCA and has a significant impact on in-hospital mortality. A number of pharmacological treatments have also been studied that can impact the progression to IHCA. Development of cardiogenic shock post-STEMI increases mortality and raises the risk of cardiac arrest. The treatment of IHCA follows the ACLS algorithm with some notable exceptions.

Keywords: Cardiac arrest; ST-segment myocardial infarction; acute coronary syndrome; acute myocardial infarction; cardiac critical care; cardiogenic shock; percutaneous coronary intervention.