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Acute coronary syndrome


Disease: Acute coronary syndrome Acute coronary syndrome
Category: Cardiovascular diseases
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Disease Definition:

Acute coronary syndrome is usually diagnosed in an emergency room or hospital. This term includes any condition brought on by sudden, reduced blood flow to the heart. Some of its symptoms may be chest pain while at rest or doing light physical activity (unstable angina), or chest pain while having a heart attack.

If diagnosed quickly, it can be treated. Its treatments vary depending on the signs, symptoms and the overall health of a person.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


If acute coronary syndrome isn't treated quickly, it can result in a heart attack, because its symptoms are the same as those of a heart attack. In case a person experiences the signs and symptoms mentioned below, they should seek immediate medical help:

  • Nausea
  • Vomiting
  • Chest pain that feels like burning (angina), in addition to pressure or tightness, which may occur with exercise, emotional stress or eating a large meal that lasts for several minutes or more.
  • Lightheadedness
  • Shortness of breath (dyspnea)
  • Pain that occurs anywhere in the body, such as the upper arm or jaw (referred pain).
  • Sudden, heavy sweating (diaphoresis)

The signs and symptoms may vary for women when having a heart attack, they may include:

  • Clammy skin
  • Unusual or unexplained exhaustion
  • Abdominal pain or pains similar to heartburn

If a chest pain feels like an emergency situation, a person should seek medical help immediately and try to get emergency medical assistance rather than driving to the hospital, because they may be having a heart attack.
When having recurrent chest pains, the doctor should be consulted because it may be a form of angina and the doctor could help decide the best course of treatment.


The building up of plaques in the arteries in the heart, known as atherosclerosis, results in acute coronary syndrome, which may develop slowly. Theses plaques are made up of fatty deposits and can end up causing the arteries to narrow, making it more difficult for blood to flow through them. This buildup can eventually cause a heart attack or angina (chest pain), because the heart can't pump enough blood rich with oxygen to the rest of the body.

Coronary artery disease, which is a term that is closely associated with acute coronary syndrome, refers to the damage to the heart arteries from atherosclerosis.

A heart attack can be caused by the rupture of one of the plaques in the coronary arteries. After a plaque ruptures, a blood clot will form on the site of the rupture, blocking the flow of blood through the artery, causing a coronary artery syndrome.





Depending on the symptoms and how blocked the arteries are, treatments could vary, including:

The patient will be recommended medications that improve the flow through the heart and relieve pain, such as:

The earlier the patient receives a thrombolytic drug after a heart attack, the greater the chance of survival and minimizing the damage to the heart. Also called clotbusters, these medications help in dissolving the blood clot that's blocking the blood flow to the heart.

Acetylsalicylic acid (aspirin):
One of the first medications given in an emergency room for suspected acute coronary syndrome is aspirin, because it decreases blood clotting and helps keep the blood flowing through narrow heart arteries. In order for acetylsalicylic acid to be absorbed into the bloodstream more quickly, the patient may be asked to chew the Pill . Daily acetylsalicylic acid therapy may be recommended to someone diagnosed with acute coronary syndrome.

Beta blockers:
To decrease the demand on the heart, this medication helps relax the heart muscle, decrease the blood pressure and slow the heart rate. It also increases blood flow through the heart, decreasing chest pain and the potential damage to the heart during a heart attack.

This medication temporarily widens narrowed blood vessels to improve blood flow to and from the heart, and is used for treating chest pain and angina.

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs):
ACE inhibitors or ARBs may be prescribed if the patient has had a moderate to severe heart attack that has reduced the heart's pumping capacity. These medications allow blood to flow from the heart more easily, lower blood pressure and may prevent a second heart attack.

Surgery may be recommended if medications aren't enough to restore blood flow through the heart, some of those procedures include:

Coronary bypass surgery:
During this procedure, the blocked portion of the artery in the heart is removed, and an artery from another part of the body such as the leg, replaces the removed portion. This procedure creates an alternative route for blood to go around the blocked coronary artery.

Angioplasty and stenting:
During this surgery, a catheter (long, thin tube) is inserted into the blocked or narrowed part of the artery and a wire with a deflated balloon is passed through the catheter to the narrowed area. This balloon is inflated, compressing the deposits against the artery walls. Usually, to help keep the artery open a stent (mesh tube) is left in it. This procedure may also be done with laser technology.


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