What is an acute coronary syndrome?
The acute coronary syndrome is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart.
An example of such conditions is a heart attack (myocardial infarction) – when cell death results in damaged or destroyed heart tissue. In some cases, acute coronary syndrome may not cause cell death but reduced blood flow changes how your heart works which is a sign of a high risk of a heart attack. This syndrome often causes severe chest pain and discomfort. It is a medical emergency that requires prompt diagnosis and care. The objectives of treatment are improving blood flow, treating complications, and preventing future problems.
What are the signs and symptoms of acute coronary syndrome?
The signs and symptoms of ACS usually begin suddenly. They include:
- Chest pain or discomfort is often described as aching, pressure, tightness, or burning. (This is the most common symptom of the acute coronary syndrome).
- Nausea or vomiting.
- Shortness of breath.
- Sudden heavy sweating.
- Pain spreading from the chest to the shoulders, arms, back, and neck or jaw.
- Feeling restless.
- Unusual fatigue.
- Lightheadedness, dizziness, or fainting.
What are some of the causes of acute coronary syndrome?
The ACS usually results from the buildup of fatty deposits (plaques) in and on the walls of coronary arteries, the blood vessels delivering oxygen and nutrients to the heart muscles. When a plaque deposit ruptures or splits, a blood clot forms. This clot blocks the flow of blood to the heart muscles. When the supply of oxygen to cells is too low, cells of the heart muscles can die. If the cells die, it results in damage to muscle tissues which causes a heart attack or myocardial infarction. In the case where there is no cell death, the decrease in oxygen still results in heart muscles that don’t work as they should. This change can be temporary or permanent. This condition where acute coronary syndrome doesn’t result in cell death is called unstable angina.
What are the risk factors for acute coronary syndrome?
Risk factors for the acute coronary syndrome are the same as those for other heart complications. Risk factors for acute coronary syndrome include:
- High blood pressure.
- High blood cholesterol.
- Cigarette smoking.
- Unhealthy diet.
- Lack of physical activity.
- Obesity or overweight.
- Family history of chest pains, heart disease, or stroke.
- Covid-19 infection.
Diagnosis for the acute coronary syndrome.
If the individual has signs and symptoms of the ACS, the emergency room doctor will order several tests.
These tests include:
Electrodes are attached to your skin to measure the electrical activity of your heart. The presence of abnormal or irregular impulses indicates your heart is not working properly. This may be due to a lack of oxygen in your heart. Moreover, certain patterns in electrical signals may show the general location of a blockage.
Certain enzymes may be detected in the blood if cell death has caused damage to the heart tissue. These two tests are used to make a primary diagnosis of the ACS. Your doctor can use this information to classify your condition as a heart attack or unstable angina. Other tests that can be carried out to know more about your condition are:
Myocardial perfusion imaging.
Computerized tomography (CT) angiogram.
These are the immediate objectives of treatment:
- Relieve pain and stress.
- Improve blood flow.
- Restore heart function as quickly as possible.
There are long term treatment goals like:
- Improving overall heart function.
- Managing risk factors.
- Lower the risk of a heart attack.
What are the medications for acute coronary syndrome?
- Thrombolytics – Help dissolve a blood clot that’s blocking an artery.
- Nitroglycerin – improves blood flow by temporarily widening blood vessels.
- Antiplatelet drugs – Help prevent blood clots from forming and include aspirin and others.
- Beta-blockers – help relax your heart muscle and slow your heart rate.
- Angiotensin-converting enzyme (ACE) inhibitors – Widen blood vessels and improving blood flow thus enabling the heart to work better.
- Angiotensin receptor blockers (ARBs) – Help control blood pressure and include irbesartan and others.
- Statins – They lower the amount of cholesterol moving in the blood and may stabilize plaque deposits, making them less likely to rupture or split.
Surgery and other procedures.
Angioplasty and stenting.
Coronary bypass surgery.