Acute Coronary Syndrome

So youve never heard of an acute coronary

syndrome. But what about heart attack,
or unstable angina? Those well-known
conditions are both acute coronary syndromes,
an umbrella term for situations where the blood
supplied to the heart muscle is suddenly
blocked.

This is an absolute medical emergency.

Something dramatic, right this minute is going
on in the arteries that is hurting the blood flow
to the heart, said Ann Bolger, M.D., a
cardiologist at San Francisco General Hospital
and a member of the American Heart
Associations Council on Clinical Cardiology.

The blockage can be sudden and complete, or it can come and go clot, break open, then clot again. In
either case, the heart tissue is dying, even if its just a few cells or a whole big section of the heart, Bolger
said.

Doctors use the broad term regularly, but usually only among themselves and in the medical literature.
Its like describing a North American state rather than just saying Texas, Bolger said. I dont think too
many doctors say, Youre having an acute coronary syndrome. They say, Youre having a heart attack.

What are the symptoms?

Chest pain or discomfort may immediately signal to you that somethings wrong with your heart. Other
symptoms, however, may leave you unsure of whats wrong. Take note of these common signs of an
acute coronary syndrome:

Chest pain or discomfort, which may involve pressure, tightness or fullness

Pain or discomfort in one or both arms, the jaw, neck, back or stomach
Shortness of breath
Feeling dizzy or lightheaded
Nausea
Sweating

These symptoms should be taken seriously. If you experience chest pain or other symptoms, call 9-1-1
immediately. People are in denial and theyre sitting there thinking, This cant really be happening to
me, Bolger said. We want them to feel entitled to call 9-1-1. Theyre not being alarmist.

Chest pain caused by acute coronary syndromes can come on suddenly, as is the case with a heart attack.
Other times, the pain can be unpredictable or get worse even with rest, both hallmark symptoms
of unstable angina. People who experience chronic chest pain resulting from years of cholesterol buildup
in their arteries can develop an acute coronary syndrome if a blood clot forms on top of the plaque
buildup.
How is it diagnosed and treated?
To determine whats causing your symptoms, a doctor will take a careful medical history and give you a
physical examination. If the doctor suspects an acute coronary syndrome, the following tests will be
performed:

A blood test can show evidence that heart cells are dying.
An electrocardiogram (ECG or EKG) can diagnose an acute coronary syndrome by measuring the
hearts electrical activity.

If tests confirm blood flow to the heart has been blocked, doctors will work quickly to reopen the artery.
Minute by minute, the heart is accumulating irreversible damage. So time is myocardium myocardium
being the heart muscle itself, Bolger said.

At San Francisco General Hospital, the goal is to have the artery reopened within an hour of the patient
entering the hospital, Bolger said. Generally, patients do best when the artery is reopened within four
hours of the first symptoms.

Treatment for acute coronary syndrome includes

medicines and a procedure known as angioplasty, during
which doctors inflate a small balloon to open the artery
(View an illustration of coronary arteries). A stent, a wire
mesh tube, may be permanently placed in the artery to
keep it open. For hospitals not equipped to do
angioplasty quickly, drugs may be used to dissolve blood
clots, but more hospitals are making the procedure
available in a timely manner, Bolger said.

Am I at risk?
Acute coronary syndromes, just like heart failure and stroke, are much more likely in people who have
certain risk factors. These include:

Smoking
High blood pressure
High blood cholesterol
Diabetes
Physical inactivity
Being overweight or obese
A family history of chest pain, heart disease or stroke
ACUTE CORONARY SYNDROME
( ACS )
ICU AREA

SUBMITTED BY: Sarah Jean Gerona

SUBMITTED TO: Mrs. Nico