Heart attack - ACS; Myocardial infarction - ACS; MI - ACS; Acute MI - ACS; ST elevation myocardial infarction - ACS; Non ST-elevation myocardial infarction - ACS; Unstable angina - ACS; Accelerating angina - ACS; Angina - unstable-ACS; Progressive angina Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the heart muscle. When blood cannot flow to the heart muscle, the heart muscle can become
damaged. Heart attack and unstable angina are both acute coronary syndromes (ACS). A fatty substance called plaque can build up in the arteries that bring oxygen-rich blood to your
heart. Plaque is made up of cholesterol, fat, cells, and other substances. Plaque can block blood flow in two ways: Many risk factors for
heart disease may lead to an ACS. You feel a tight band of pain around your chest. The pain moves from your chest to your arms, shoulder, and neck. What could your pain mean? Could it be a heart attack, could it be the big one? Heart attacks are caused by
interruption of blood supply to part of the heart. If the blood flow is blocked, your heart is starved of oxygen and heart cells die. A hard substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack can occur as a result of plaque buildup or the rupture of one of these plaques. We're not sure why heart attacks occur when they do. You may have a heart attack when you are resting or asleep, or after a sudden
increase in physical activity, when you are outside in cold weather, or after a sudden, severe emotional or physical stress, including an illness. So, how is a heart attack treated? If you go to the hospital for a suspected heart attack, a doctor or nurse will listen to your chest with a stethoscope. You will have a blood test to look for heart damage. A coronary angiography test can show your doctor how well blood is moving through your heart. If blood moves slowly, or not at all through your
coronary arteries, you have either a narrowed, or blocked artery. Other tests can look at the valves and chambers of your heart and check for abnormal heart rhythms. If you've had a heart attack, doctors can do an emergency procedure called angioplasty. This surgery or procedure can open narrowed or blocked blood vessels. Usually they'll place a small, metal mesh tube, called a stent, in your artery to help keep it open. You may also receive drugs to break up the clot in your artery. Sometimes,
doctors will do heart bypass surgery to get blood flowing to your heart muscle again. After you are treated in the hospital for a heart attack, you may need to take medicines to thin your blood, to protect your heart, or to improve your cholesterol levels. You may need to take these medicines for the rest of your life. Most people who have had a heart attack also need cardiac rehabilitation. This will help you slowly increase your exercise level and learn how to follow a healthy lifestyle. After
you have a heart attack, your chance of another is higher. How well you do after a heart attack depends on the damage to your heart and where the damage is, and what steps you take to prevent another one. If your heart can no longer pump blood to your body as well as it used to, you may have heart failure and will need lifelong treatment. Usually a person who has had a heart attack can slowly go back to normal activities, but you will need to take steps to prevent another heart attack. SymptomsThe most common symptom of ACS is chest pain. The chest pain may come on quickly, come and go, or get worse with exercise or rest. Other symptoms can include:
Women and older people often experience these other symptoms, although chest pain is common for them as well. Exams and TestsYour health care provider will do an exam, listen to your chest with a stethoscope, and ask about your medical history. Tests for ACS include:
Coronary angiography may be done right away or when you are more stable. This test:
Other tests to look at your heart that may be done while you are in the hospital include:
TreatmentYour provider may use medicines, surgery, or other procedures to treat your symptoms and restore blood flow to your heart. Your treatment depends on your condition and the amount of blockage in your arteries. Your treatment may include:
Outlook (Prognosis)How well you do after an ACS depends on:
In general, the quicker your artery gets unblocked, the less damage you will have to your heart. People tend to do best when the blocked artery is opened within a few hours from the time symptoms start. Possible ComplicationsIn some cases, ACS can lead to other health problems including:
When to Contact a Medical ProfessionalAn ACS is a medical emergency. If you have symptoms, call 911 or the local emergency number quickly. Do not:
PreventionThere is a lot you can do to help prevent ACS.
ReferencesAmsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/. Bohula EA, Morrow DA. ST-elevation myocardial infarction: management. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 38. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-S99. PMID: 24222015 pubmed.ncbi.nlm.nih.gov/24222015/. Giugliano RP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 39. O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):529-555. PMID: 23247303 pubmed.ncbi.nlm.nih.gov/23247303/. Scirica Benjamin M, Libby P, Morrow DA. ST-elevation myocardial infarction: pathophysiology and clinical evolution. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 37. Version InfoLast reviewed on: 5/8/2022 Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What are examples of acute coronary syndromes?Acute coronary syndrome refers to a group of diseases in which blood flow to the heart is decreases. Some examples include ST-elevation myocardial infarction, non-ST elevation myocardial infarction, and unstable angina.
What are the three types of acute coronary syndrome?The term acute coronary syndrome (ACS) is applied to patients in whom there is a suspicion or confirmation of acute myocardial ischemia or infarction. Non-ST-elevation myocardial infarction (NSTEMI), ST-elevation MI (STEMI), and unstable angina are the three traditional types of ACS.
What are the two major acute coronary syndromes?The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina (UA), non—ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).
What are the main symptoms of acute coronary syndrome?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.. |