Acute coronary syndrome (ACS) is a serious problem in which there is suddenly not enough blood and oxygen reaching the heart. ACS can result in chest pain or a heart attack.
This condition is a medical emergency. If you have any symptoms of this condition, get help right away.
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6 Interesting Facts of Acute Coronary Syndrome
- Group of clinical symptoms associated with acute myocardial ischemia, including unstable angina and myocardial infarction (ST-elevation myocardial infarction and non-ST-segment elevation myocardial infarction), usually resulting from coronary artery disease
- Presenting patterns in patients with angina that mimic myocarditis include chest pain, dyspnea, syncope, and fatigue
- ECG findings (eg, ST-segment elevation or depression, T-wave inversion, Q waves) may be similar between conditions; findings in patients with myocarditis may be diffuse or reflect coronary or noncoronary distribution pattern
- Cardiac troponin levels may be elevated in both conditions
- Differentiate by clinical presentation, clinical course, and ancillary test findings including echocardiogram; cardiac MRI; and radionucleotide testing, coronary angiography, or both, depending on individual presentation
- Diagnostic confirmation of myocardial infarction usually involves a combination of factors including consistent clinical presentation, ECG findings, supportive biomarker profile, and imaging studies
What are the causes of Acute Coronary Syndrome ?
Acute Coronary Syndrome may be caused by:
- Buildup of fat and cholesterol inside of the arteries (atherosclerosis). This is the most common cause. The buildup (plaque) can cause blood vessels in the heart (coronary arteries) to become obstructed or narrowed, therby reducing the blood flow to the heart. Plaque can also break off and lead to a clot, which can block an artery and cause a heart attack or stroke.
- Sudden tightening of the muscles around the coronary arteries (coronary spasm).
- Tearing of a coronary artery (spontaneous coronary artery dissection).
- Very low blood pressure (hypotension).
- An abnormal heartbeat (arrhythmia).
- Other medical conditions that cause a decrease of oxygen to the heart, such as anemiaorrespiratory failure.
- Using cocaine or methamphetamine.
What are the Risk Factors of Acute Coronary Syndrome ?
The following factors may make you more likely to develop this condition:
- Age. The risk for ACS increases as you get older.
- History of chest pain, heart attack, peripheral artery disease, or stroke.
- Having taken chemotherapy or immune-suppressing medicines.
- Being male.
- Family history of chest pain, heart disease, or stroke.
- Smoking.
- Not exercising enough.
- Being overweight.
- High cholesterol.
- High blood pressure (hypertension).
- Diabetes.
- Excessive alcohol use.
What are the signs or symptoms of ACS?
Common symptoms of Acute Coronary Syndrome include:
- Chest pain. The pain may last a long time, or it may stop and come back (recur). It may feel like:
- Crushing or squeezing.
- Tightness, pressure, fullness, or heaviness.
- Arm, neck, jaw, or back pain.
- Heartburn or indigestion.
- Shortness of breath.
- Nausea.
- Sudden cold sweats.
- Light-headedness.
- Dizziness, or passing out.
- Tiredness (fatigue).
Sometimes there are no symptoms.
How is this diagnosed?
This condition may be diagnosed based on:
- Your medical history and symptoms.
- An electrocardiogram (ECG). This imaging test measures the heart’s electrical activity.
- Blood tests. Cardiac blood tests may need to be repeated at designated time intervals.
- Chest X-ray.
- A CT scan of the chest.
- A coronary angiogram. This is a procedure in which dye is injected into the bloodstream and then X-rays are taken to show if there is a blockage in a coronary artery.
- Exercise stress testing.
- Echocardiography. A diagnostic procedure which utilizes the sound waves to produce detailed images of the heart.
How is this treated?
The treatment is to restore blood flow to the heart as soon as possible. Treatment for this condition may include:
- Oxygen therapy.
- Medicines, such as:
- Antiplatelet medicines and blood-thinning medicines, such as aspirin. These help prevent blood clots.
- Medicine that dissolves any blood clots (fibrinolytic therapy).
- Blood pressure medicines.
- Nitroglycerin. This helps relieve chest pain and widens blood vessels to improve blood flow.
- Pain medicine.
- Cholesterol-lowering medicine.
- Surgery, such as:
- Coronary angioplasty with stent placement. This involves placing a small piece of metal that looks like mesh or a spring into a narrow coronary artery. This widens the artery and keep it open.
- Coronary artery bypass surgery. This involves taking a section of a blood vessel from a different part of your body, and placing it on the blocked coronary artery to allow blood to flow around (bypass) the blockage.
- Cardiac rehabilitation. This is a program that helps improve your health and well-being. It includes exercise training, education, and counseling to help you recover.
Follow these instructions at home:
Eating and drinking
- Start a heart-healthy diet which comprises of whole grains, fruits and vegetables, lean proteins, and low-fat or nonfat dairy products.
- Limit how much salt (sodium) you eat as told by your health care provider. Discuss with your consulting physician about any other eating or drinking restrictions, which might include reducing the foods which are high in fat and processed sugars.
- Use healthy cooking methods such as roasting, grilling, broiling, baking, poaching, steaming, or stir-frying.
- Talk with a dietitian to learn about healthy cooking methods and how to eat less sodium.
Medication
- Talk to your physician regarding any over-the-counter and prescription medicines only as per their advise.
- Avoid these medicines unless your health care provider approves:
- Vitamin supplements that contain vitamin A or vitamin E
- NSAIDs
- Hormone replacement therapy that contains estrogen
If you are taking blood thinners:
- Discuss with your consulting physician before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.
- Take your medicine exactly as told, at the same time every day.
- Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.
- It is advised to carry a medical alert bracelet, along with a card which have the details of the medicines you take.
Activity
- Join a cardiac rehabilitation program which has the exclusive options to prepare an exercise plan for you.
- Ask your health care provider:
- What activities and exercises are safe for you.
- If you should follow specific instructions about lifting, driving, or climbing stairs.
Lifestyle
- Avoid use of any products that contain nicotine or tobacco, such as cigarettes. Seek the help of your family physician in case If you require assistance in quitting, ask your health care provider.
- Discuss with your family physician regarding your alcohol intake and check whether alcohol is safe for you, restrict your intake to not more than a single drink a day. One drink equals approxiamtely to12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
- Maintain a healthy weight. If you need to lose weight, work with your health care provider to do so safely.
General instructions
- Tell all the health care providers who care for you about your heart condition, including your dentist. This may affect the medicines or treatment you receive.
- Monitor any other co morbid health diseases if you have, such as hypertension or diabetes as these conditions affect your heart.
- Learn ways to manage stress.
- Get screened for depression, and get mental health treatment if you need it. People with ACS are at higher risk for depression.
- Keep your vaccinations up to date. Get the flu shot (influenza vaccine) every year.
- If directed, monitor your blood pressure at home.
- It is mandatory to maintain all your follow-up visits after discussing with your family physician.
Contact a health care provider if:
- You feel overwhelmed or sad.
- You have trouble doing your daily activities.
Get help right away if:
- You have pain in your chest, neck, arm, jaw, stomach, or back that recurs, and:
- It lasts for more than a few minutes.
- It is not relieved by taking the medicineyour health care provider prescribed.
- You have unexplained:
- Heavy sweating.
- Heartburn or indigestion.
- Nausea or vomiting.
- Shortness of breath.
- Difficulty breathing.
- Fatigue.
- Nervousness or anxiety.
- Weakness.
- Diarrhea.
- Dark stools or blood in your stool.
- You have sudden light-headedness or dizziness.
- When your blood pressure reaches more than 180/120 mmHg.
- You faint.
- You have thoughts about hurting yourself.
The listed symptoms might indicate an emergency. It might turn out to a serious problem if you wait to watch until the symptoms subsides. Do not delay to seek the medical help immediately. Contact your local emergency services right away. Do not drive yourself to the hospital.
If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:
Summary
- Acute coronary syndrome (ACS) is when there is not enough blood and oxygen being supplied to the heart. ACS can result in chest pain or a heart attack.
- Acute coronary syndrome is a medical emergency. If you have any symptoms of this condition, get help right away.
- Treatment includes medicines and procedures to open the blocked arteries and restore blood flow.
