What is Acute Coronary Syndrome?
Acute coronary syndrome (ACS) is a medical term used to describe problems that occur when there is reduced or insufficient blood flow to the heart. It is a medical emergency requiring immediate diagnosis and care. Heart attack (myocardial infarction) and unstable angina (chest pain) are the two most common examples associated with acute coronary syndrome.
Causes of Acute Coronary Syndrome
The acute coronary syndrome usually occurs when cholesterol and plaque accumulate inside the coronary arteries, blocking the flow of oxygen-rich blood to heart muscles. Plaque fragments can sometimes break off and form a blood clot that can completely block the vessels, leading to permanent heart damage.
Symptoms of Acute Coronary Syndrome
Symptoms may not manifest in the initial stages when there is a decrease in blood flow but may show up as the plaque continues to build. Some common symptoms of acute coronary syndrome include:
- Angina (chest pain), characterized by pain, discomfort, heaviness, tightness or numbness in the chest; pain can also radiate to the neck, jaw, back, shoulder, or arms
- Burning sensation in the chest
- Shortness of breath
- Dizziness, fainting, or lightheadedness
- Fatigue
- Heavy sweating
- Nausea or Vomiting
The signs and symptoms may differ from person to person based on their sex, age, and any medical conditions present.
Risk Factors of Acute Coronary Syndrome
Some of the risk factors associated with the acute coronary syndrome include:
- Smoking
- Insufficient physical activity
- Excessive alcohol intake
- Diabetes
- Being overweight or obese
- Unhealthy diet
- Aging
- Elevated blood pressure
- Elevated blood cholesterol
- Family history of heart disease, chest pain, or stroke
Diagnosis of Acute Coronary Syndrome
Your doctor will perform a physical examination and review your medical and family history.
Procedures that may be used to diagnose acute coronary syndrome can include:
- Electrocardiogram (ECG) to record the heart’s electrical activity
- Echocardiogram to view the heart’s size, structure, and motion using sound waves
- Stress test to record the heart’s electrical activity while you run on a treadmill
- Coronary angiogram to view the flow of blood using a special dye and x-rays
- Computerized tomography (CT) angiogram to detect blocked or narrowed arteries using specialized x-ray technology
- Blood tests to look for certain enzymes in the blood that can indicate damage to heart tissue
Treatment for Acute Coronary Syndrome
The immediate objective of treatment for acute coronary syndrome is to improve blood flow, relieve pain and distress, and to restore the function of the heart as soon as possible.
The long-term treatment objective is to manage risk factors, reduce the chances of heart attack, and enhance the overall function of the heart.
These treatment goals can be achieved through lifestyle changes, medications, and surgery.
Lifestyle changes
Adopting a healthy lifestyle that incorporates plenty of physical activity, a heart-healthy diet, limited alcohol intake, smoking cessation, and a good weight-management regime will go a long way in managing acute coronary syndrome.
Medications
Medications are recommended if risk factors cannot be lowered through lifestyle changes. These medications may include beta-blockers, nitroglycerin, statins, angiotensin receptor blockers (ARBs), and angiotensin-converting enzyme (ACE) inhibitors.
Surgery
Certain procedures can be employed to open up the blocked arteries, including:
- Balloon angioplasty and stenting: An inflated balloon is inserted into the blocked artery to compress the deposits against the arterial wall. Sometimes a stent is placed and left in the artery to keep it open.
- Coronary artery bypass surgery (CABG): A blood vessel from another part of the body is used to create a graft to bypass the blocked artery and improve coronary blood flow.
