STEMI · ACS

Door-to-balloon
0:00
0/9 activation steps · goal ≤ 90 min
≈ 154.3 lb
AI ECG check · rhythm / blocks / ischemia
Decision support

Upload or photograph a 12-lead ECG. AI will assess rhythm, intervals, conduction blocks, ischemia/STEMI, and other abnormalities, with prioritized ED management. Never replaces physician interpretation.

Management
Antiplatelet (loading)
  • : 324 mg PO chewed (4 × 81 mg)
  • : 180 mg PO load, then 90 mg BID
  • : 60 mg PO load (avoid if > 75 yo, < 60 kg, prior stroke/TIA)
  • : 600 mg PO load (300 mg if fibrinolytic + age > 75)
  • Coordinate P2Y12 choice with cath team — practices vary.
Anticoagulation (weight-based)
  • Heparin bolus (60 u/kg)
    4,000 u
    max 4000 u
    Heparin infusion (12 u/kg/h)
    840 u/h
    max 1000 u/h
    Enoxaparin SC < 75 yo
    70 mg
    + 30 mg IV bolus, q12h
    Enoxaparin SC ≥ 75 yo
    53 mg
    no bolus, q12h
  • Bivalirudin alternative: 0.75 mg/kg IV bolus + 1.75 mg/kg/h infusion (PCI).
Fibrinolytic (if PCI > 120 min)
  • Tenecteplase () — single IV bolus
    40 mg
    Weight-tiered: <60 kg→30 · 60–69→35 · 70–79→40 · 80–89→45 · ≥90→50 mg
    Half-dose for age ≥ 75 per some protocols (STREAM).
Absolute contraindications (fibrinolytic)
  • (AVM)
  • 3 months (except acute < 4.5 h)
  • 3 months
  • 2 months
Relative contraindications (fibrinolytic)
  • (> 10 min)
  • 3 weeks
  • (2–4 wk) internal bleeding

Educational aid only — verify against local STEMI / cath lab protocol.