What is acute coronary syndrome?

Acute Coronary Syndrome

Acute coronary syndrome (ACS) is an event that occurs when part of the heart muscle is not getting enough blood and oxygen. ACS includes unstable angina and a heart attack. In a heart attack, the heart muscle is injured or starts to die. ACS is an emergency.

ACS is most often caused by a narrowed or blocked coronary artery. The coronary arteries supply blood to the heart muscle. The narrowing or blockage is usually the result of coronary artery disease, in which fatty deposits called plaque (say "plak") build up inside the arteries. If the plaque breaks open or ruptures, a blood clot may form and limit or block blood flow to the heart muscle.

What are the symptoms of acute coronary syndrome?

Symptoms of acute coronary syndrome include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Shortness of breath.
  • Sweating.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
  • Lightheadedness, sudden weakness, or passing out.
  • A fast or irregular heartbeat.

The most common symptom is chest pain or pressure. But many people have other symptoms like shortness of breath, tiredness, nausea, and back or jaw pain. People may have more than one symptom.

People also describe the symptoms as discomfort, pressure, squeezing, or heaviness in the chest. The pain may spread down the left shoulder and arm and to other areas.

People with unstable angina often describe their symptoms as different from their typical pattern of stable angina. For example, symptoms might happen when they're at rest, feeling stressed, or not using much energy.

How is acute coronary syndrome treated?

If you call 911, treatment will start in the ambulance. You may be given aspirin, oxygen, and pain medicine.

In the hospital, the doctor will work right away to return blood flow to your heart. You may be given:

  • Medicine for blood clots. Some medicine prevents blood clots from getting bigger so blood can flow to the heart. Other medicines break up blood clots to increase blood flow.
  • Nitroglycerin. It opens up the arteries of the heart to help blood flow back to the heart.

You may be given other medicine, such as a beta-blocker.

Your test results will help your doctor decide about more treatment. You might have angioplasty or bypass surgery to improve blood flow to your heart.

Your doctors will start you on medicines that lower your risk of having acute coronary syndrome again. Or you may get medicines that lower your risk of having other problems and that help you live longer. They include medicine to:

  • Lower blood pressure.
  • Lower cholesterol.
  • Lower the heart's workload.
  • Prevent blood clots from forming and causing a heart attack.

Cardiac rehabilitation (rehab) might be started in the hospital or soon after you go home. It can help you have a heart-healthy lifestyle which can lead to a stronger heart and better health. Cardiac rehab can help you feel better and reduce your risk for future heart problems. If cardiac rehab has not already been offered to you, ask your doctor if it's right for you.

How can you prevent acute coronary syndrome?

A heart-healthy lifestyle and medicine can help prevent acute coronary syndrome.

  • Try to quit or cut back on using tobacco and other nicotine products. If you need help quitting, talk to your doctor about stop-smoking programs and medicines.
  • Eat heart-healthy foods. These include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit alcohol, sodium, and sugar.
  • Try to be active for 30 minutes of activity on most days of the week. Ask your doctor what level of exercise is safe for you.
  • Stay at a weight that's healthy for you. Talk to your doctor if you need help losing weight.
  • Manage other health problems, including diabetes, high blood pressure, and high cholesterol.
  • Try to get 7 to 9 hours of sleep each night.
  • Take a medicine that prevents blood clots if your doctor advises it.
  • If you think you may have a problem with alcohol or drug use, talk to your doctor.

How is acute coronary syndrome diagnosed?

To check for acute coronary syndrome, your doctor will take a history and do a physical exam. You will have an electrocardiogram and a blood test that can show signs of heart damage. Imaging tests or a coronary angiogram may be done to check how well blood is flowing to the heart muscle.

How can you care for yourself after having acute coronary syndrome?

You can care for yourself by taking medicine as prescribed and having a heart-healthy lifestyle. This lifestyle includes being active, eating healthy, and not smoking. You can manage other health problems, including diabetes, high blood pressure, and high cholesterol. If you think you may have a problem with drug use, talk to your doctor.

What is acute coronary syndrome?

Acute coronary syndrome is an emergency. It happens when the heart is not getting enough blood. The coronary arteries supply oxygen-rich blood to the heart muscle. If these arteries are narrowed or blocked, the heart doesn't get enough oxygen. Acute coronary syndrome includes unstable angina and a heart attack.

What causes acute coronary syndrome?

It is caused when not enough blood and oxygen reach part of the heart muscle. This most often happens because one or more of the coronary arteries becomes narrowed or blocked. This narrowing or blockage is usually caused by a blood clot that forms when plaque in the artery breaks open.

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