Description

Acute coronary syndrome is a term that describes a variety of conditions related to the sudden decrease of blood flow to the heart. These conditions include heart attack and unstable angina, a type of chest pain.

When the flow of blood to the heart is reduced, the heart muscle does not receive enough oxygen. If the heart of the cells of the tissues that die or are damaged, of a heart attack. A heart attack is also known as a myocardial infarction.

Unstable angina occurs when the blood flow to the heart decreases. It is not severe enough to cause the heart tissue, the cells die or have a heart attack. But the reduction of the blood flow may increase your risk of a heart attack.

Acute coronary syndrome often causes severe chest pain or discomfort. It is a medical emergency that requires immediate diagnosis and immediate attention. The goals of treatment are to improve the flow of blood and prevent and treat complications.

Symptoms

The symptoms of acute coronary syndrome usually begin suddenly. They include:

  • Chest pain or discomfort. It can feel like pain, pressure, tightness or burning. Chest pain, also called angina.
  • The pain that begins in the chest and spreads to other parts of the body. These areas include shoulders, arms, upper abdomen, back, neck, or jaw.
  • Nausea or vomiting.
  • Pain or burning in the upper part of the abdomen, called indigestion.
  • Shortness of breath, also called dyspnea.
  • Suddenly, a strong sweating.
  • Beats of the heart.
  • Feelings of dizziness or vertigo.
  • Fainting.
  • Unusual fatigue.

Chest pain or discomfort is the most common symptom of acute coronary syndrome. But the symptoms can vary greatly depending on the age, the sex assigned at birth, and other medical conditions. Women, older adults, and people with diabetes are more likely to have symptoms without chest pain or discomfort.

When to see a doctor

Acute coronary syndrome is a medical emergency. Chest pain or discomfort can be a symptom of many life-threatening conditions. Get emergency help immediately for a diagnosis and the appropriate care. Do not drive yourself to the hospital.

Causes

Acute coronary syndrome is usually caused by a buildup of fatty deposits on the walls of the arteries of the heart. The fatty deposits are also called plaque. When a deposit of fat breaks, a blood clot can form. This clot blocks the flow of blood to the heart. The heart muscle does not receive enough oxygen.

The lack of oxygen can cause the cells in the heart muscle to die. The damage can lead to a heart attack. When the acute coronary syndrome does not cause the heart muscle cells to die, which is called unstable angina.

Risk factors

Risk factors for acute coronary syndrome are the same as those of other types of heart disease. The risk factors include:

  • Advanced age.
  • The high blood pressure.
  • High cholesterol in the blood.
  • Smoking or consumption of tobacco.
  • There is not enough physical activity.
  • An unhealthy diet.
  • Obesity or being overweight.
  • Diabetes.
  • A Personal or family history of chest pain called angina, a heart attack or stroke.
  • History of high blood pressure, preeclampsia or diabetes during pregnancy.
  • The early menopause.
  • COVID-19 infection.

Diagnosis

Acute coronary syndrome is an emergency. It is usually diagnosed in a hospital. The health team performs tests to check the heart and determine the cause of the symptoms. Some tests may be done while the health care team will ask about your symptoms or medical history.

Tests

Testing for acute coronary syndrome may include:

  • The electrocardiogram. This quick test, also called an ECG or EKG, which shows how the heart is beating. Adhesive patches with sensors attached to the chest and, at times, the arms or the legs. Changes in the heart rhythm that may mean that the heart is not working as it should. Your health care professional may look for patterns in the beats of the heart to find the general location of the locks.
  • Blood tests. Some heart proteins slowly leak into the blood after heart damage from a heart attack. Blood tests may be done to check these proteins.

Your health care team looks at your symptoms and the results of the test to diagnose acute coronary syndrome. This information can also help to classify your condition as a heart attack or unstable angina.

Other tests may be done to rule out other possible causes of symptoms. The tests can also help determine the treatment.

  • The coronary angiography. This test for blockages in the arteries of the heart. A doctor places a thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. Is guided into the heart. Contrast medium flows through the tube of the arteries in the heart. The dye helps the arteries are shown more clearly in the images taken during the test. Some heart treatments can be performed during this test.
  • The echocardiogram. Sound waves create images of the beating heart. This test shows how the blood flows through the heart and the heart valves. An echocardiogram can show whether the heart is pumping as it should.
  • Myocardial perfusion imaging. This test shows how well blood flows through the heart muscle. A small, safe amount of radioactive substance is administered through a vein. A special camera takes pictures of the substance that moves through the blood vessels of the heart. The test helps to identify areas of poor blood flow or damage in the heart.
  • Computed tomography angiography. This test looks at the arteries that supply blood to the heart. Used a powerful X-ray machine to produce images of the heart and its blood vessels. The test can detect any build-up of plaque in the walls of the coronary artery walls.
  • Exercise stress test. A stress test shows how well your heart works when you exercise. It often consists of walking on a treadmill or riding a stationary bike while the heart is on. If you are unable to do exercise, you could get a drug that affects the heart as the exercise you do. This test is performed only when you do not have symptoms of acute coronary syndrome, or other life threatening disease of the heart when it is at rest. Other tests may be done during the stress test to see how well the heart works.

Treatment

The immediate goals of treatment for acute coronary syndrome are:

  • Relieve the pain and the anguish.
  • Improve the flow of blood.
  • To restore the function of the heart and quickly as possible.

Long-term goals of treatment are to:

  • Help the heart work better.
  • Manage risk factors.
  • To decrease the risk of a heart attack.

Treatment may include medications and cardiac procedures or surgery.

Medications

Medicines are given to treat the symptoms of acute coronary syndrome and to prevent complications.

  • Clot busters to help dissolve a blood clot that blocks an artery. These drugs are also known as thrombolytics.
  • Nitroglycerin improves the flow of blood by the temporary widening of the blood vessels.
  • Antiplatelet drugs help prevent the formation of blood clots. They include aspirin, clopidogrel (Plavix) and prasugrel (Effient).
  • Beta-blockers help relax the heart muscle and slow the heart rate. They decrease the demand on your heart and blood pressure. Examples include metoprolol (Lopressor, Toprol-XL), and nadolol.
  • Angiotensin-converting enzyme inhibitors, also called ACE inhibitors, dilate the blood vessels and improve blood flow. This helps the heart work better. Examples include lisinopril (Qbrelis, Zestril), benazepril (Lotensin), and others.
  • Blockers of receptors of angiotensin-converting enzyme 2, also called Bra, helps to control the blood pressure. They include irbesartan (Avapro), losartan (Cozaar), and others.
  • Statins reduce the amount of cholesterol in the blood. You can stabilize the fatty deposits, making them less likely to break and form a blood clot. Statins include atorvastatin (Lipitor, Atorvaliq), simvastatin (Zocor, Flolipid), and others.
  • Other cholesterol-lowering medications , such as ezetimibe (Zetia).

Surgery and other procedures

Your health care professional may recommend a cardiac procedure or surgery to restore blood flow to the heart:

  • Angioplasty and stent placement. This treatment uses a thin, flexible tube and a small balloon to open the clogged arteries of the heart. A surgeon inserts the tube into a blood vessel, usually in the groin or the wrist, and the guide for the narrowing of the artery of the heart. A wire with a deflated balloon at the tip is passed through the tube. The balloon is inflated, widening the artery. The balloon is deflated and removed. A mesh tube, called a stent is usually placed in the artery to help keep it open.
  • Coronary artery Bypass graft, also called a graft, or CABG — pronounced "cabbage." This surgery involves taking a healthy blood vessel from the chest or in the area of the leg. This piece of healthy tissue is called a skin graft. A surgeon attaches the ends of the graft below the blockage in an artery of the heart. This creates a new path for the flow of blood to the heart.

Lifestyle and home remedies

Lifestyle changes can help keep the heart healthy. Try these tips:

  • Do not smoke or use tobacco. If you smoke, stop smoking. Talk with your health care team if you need help to stop smoking. Also avoid second-hand smoke.
  • Eat healthy foods. Choose fruits, vegetables and whole grains. Limit the amount of sugar, salt and saturated fat.
  • Be active. Regular exercise helps improve the health of the heart. Try to do at least 30 minutes of moderate or vigorous physical activity five or more days a week. Talk with your health care team about the amount and type of exercise is best for you.
  • Control cholesterol levels. Your blood cholesterol levels regularly in a doctor's office. Avoid the high-fat, high-cholesterol meat and dairy. If you have high cholesterol, your health care professional may recommend a medication to lower it.
  • Control of blood pressure. Uncontrolled high blood pressure increases the risk of serious health conditions. Have your blood pressure checked regularly by your health care professional. Ask what your blood pressure reading is the best for you.
  • Maintain a healthy weight. Too much weight strains the heart. It can also lead to high cholesterol levels, high blood pressure, diabetes, heart disease, and other conditions. Talk with your health care team to set realistic goals for weight.
  • Manage stress. Find ways to help reduce emotional stress. The following are some tips for doing more exercise, practice mindfulness and connecting with others in support groups.
  • Limit the consumption of alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Practice good sleep habits. Lack of sleep can increase the risk of heart disease and other chronic conditions. Adults should try to get 7 to 9 hours of sleep daily. Go to bed and wake up at the same time every day, including weekends. If you have trouble sleeping, talk with your health care team about strategies that might help.

Preparing for your appointment

If you have sudden chest pain or other symptoms of acute coronary syndrome, get emergency care immediately or call 911.

How to describe your symptoms to the help of a computer emergency doctor make a diagnosis. Be prepared to answer the following questions.

  • When did the symptoms begin?
  • How long does it last?
  • What symptoms are you currently?
  • How would you describe the pain?
  • Where is the pain located?
  • On a scale of 1 to 10, with 10 being the worst, how bad is the pain?
  • Is there something that the symptoms better or worse?
Symptoms and treatment of Acute coronary syndrome