Acute Coronary Syndrome refers to the three types of disorders related to the arteries supplying blood to the heart (coronary arteries). In these disorders, the blood flow to the heart stops due to the blockage in the coronary arteries, which can result in damage and death of the heart tissue. It can cause symptoms like chest pain, shortness of breath, nausea, vomiting, sweating, etc. The symptoms may be atypical or less evident in people with Diabetes Mellitus, women, and old age. It is a life-threatening condition that needs prompt diagnosis and treatment.
Your heart is composed of muscles that contract to pump blood throughout the body. These muscles themselves are fed by the blood vessels called the coronary arteries. Acute coronary syndromes are caused by a partial or complete blockage of the coronary vessels due to atherosclerosis. Atherosclerosis refers to the deposition of small fatty deposits (atherosclerotic plaque) in the blood vessels causing obstruction and impedance to the blood flow. With time, this fatty deposit causes injury in the lining of the blood vessels, attracting platelets and other coagulation factors leading to the formation of a blood clot called thrombus that can increase in size gradually until it results in complete blockage of the artery.
Three different types of conditions come under the umbrella term of acute coronary syndrome based on the duration of symptoms, blood test results, and the presence or absence of ECG changes (ST elevation).
Having one or more of the following risk factors may increase your chances of developing Acute Coronary Syndrome.
Coronary artery disease is the most common type of heart disease prevalent in the USA. It affected 18.2 million adults and resulted in the deaths of 360,900 people in 2019.
It would be beneficial for you to be aware of the signs and symptoms of Acute Coronary Syndrome to act vigilantly and reach out for immediate care.
If you feel any of the above symptoms, seek immediate help by reaching out to your healthcare provider. He would take a quick history with a focused examination, and you may be advised to undergo one or more of the following tests for confirmation of acute coronary syndrome.
The electrical activity of the heart is measured in this fast procedure. Adhesive plugs (electrodes) are applied to the chest and the arms and legs in some cases. The electrodes are connected to a computer through wires, which shows findings. An Electrocardiogram can reveal whether the heart is beating excessively quickly, slowly, or not at all. The ECG may suggest that you've had or are experiencing a heart attack because wounded muscle tissue doesn't conduct electrical signals in a regular pattern.
Increased amounts of specific proteins or enzymes found in cardiac muscle may be detected by blood testing. Injury to cardiac tissue caused by a heart attack may enable these proteins or enzymes to escape into the bloodstream over several hours.
A chest X-ray can reveal the state of the lungs and the size of the heart and main blood channels. Lung disorders such as pneumonia or a collapsed lung can also be revealed by a chest X-ray.
Coronary catheterization is a procedure that involves inserting a catheter into the coronary artery. This procedure allows doctors to see if there are any obstructions in the heart vessels. A catheter is a long, narrow, flexible tube placed into a blood channel and directed toward the heart, generally in the pelvis or forearm. Dye is delivered to the heart vessels via the catheter. The dye makes X-ray images and shows the arteries more effectively. This test is also known as a coronary angiogram.
The symptoms of acute coronary syndrome may mimic the symptoms caused by some other conditions;
Immediate treatment of acute coronary syndrome focuses on relieving the obstruction in the artery to resrtore the blood flow and save the dying heart tissue, hence reducing the symptoms of pain and distress. Aftercare includes lifestyle changes, smoking cessation, treatment of the risk factors (like DM, and hypertension), and medications.
The following medications can be used;
Nitroglycerin: This allows blood to flow more freely through the restricted gaps as it relaxes the arteries.
Thrombolytic medications: These medications remove the clot that prevents blood from flowing to the heart muscle. Examples include Streptokinase, tPA, reteplase, etc.
Beta-blockers: They slow down the heart rate so the oxygen demand of the heart muscle is lessened. They also improve blood flow to the heart by relaxing the blood vessels. For example, Metoprolol, Propranolol.
Angioplasty: This is the most common treatment for chest pain due to an obstruction in a heart artery. A catheter with a balloon on the tip is inserted into the blood channel, generally in the pelvis, and guided to the obstruction. The balloon is inflated to expand the vessel, then deflated and the catheter is removed. A tiny stent is frequently kept on the outside of the catheter's balloon tip. The stent expands and seals into position, keeping the artery intact.
Bypass Surgery: It is a procedure that involves the removal of a portion of a blood vessel from some other body part to establish a passage for blood to bypass the clogged artery.
The prognosis depends on how well the patient adheres to the treatment plan, the degree of obstruction, comorbid diseases, and their control. Smoking cessation is very important. The outcome is usually good if a patient takes all his medicines regularly and adopts a healthy lifestyle. Otherwise, untreated angina will ultimately lead to a heart attack.
Adopting the following lifestyle changes may prevent you from developing coronary heart disease and angina.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 10, 2023.