ST elevation myocardial infarction magnesium therapy

For patient information click here

Associate Editor-In-Chief:

Poential Mechanism of Action
Magnesium administration is associated with vasodilation and some mild antiplatelet effects. Magnesium administation is useful in the managment of Torsades de pointes.

Randomized Trial Data
The safety and effectiveness of magnesium in the management of STEMI patients was evaluated in a series of 15 studies enrolling 68,684 patients between 1980 and 2002. The randomized data does not support the routine administration of magnesium to patients with ST elevation MI.

Indications
Magnesium can continue to be administered for repletion of documented electrolyte deficits and life-threatening ventricular arrhythmias such as torsade de pointes.

==ACC / AHAGuidelines (DO NOT EDIT) ==

{{cquote|

Class IIa
1. It is reasonable that documented magnesium deficits be corrected, especially in patients receiving diuretics before the onset of STEMI. (Level of Evidence: C)

2. It is reasonable that episodes of torsade de pointes type VT associated with a prolonged QT interval be treated with 1 to 2 grams of magnesium administered as an IV bolus over 5 minutes. (Level of Evidence: C)

Class III
1. In the absence of documented electrolyte deficits or torsade de pointes type VT, routine intravenous magnesium should not be administered to STEMI patients at any level of risk. (Level of Evidence: A)}}