Acute Coronary Syndrome

Acute Coronary Syndrome is a term used to describe the set of signs and symptoms (syndrome) associated with the myocardial ischemia, which results from the lack of sufficient blood supply to the heart muscles.

Acute Coronary Syndrome points toward an inevitable problem that has to do with a person's heart. This is particularly true when the heart muscles are unable to receive an adequate supply of blood, which in turn causes the symptoms of chest pain, among many other symptoms. When the arteries leading to the heart become too narrow due to a build-up of plaque, this blocks the flow of blood and oxygen to the heart. Eventually, this leads to the development of angina, or even a heart attack.

Though Acute Coronary Syndrome is usually associated with coronary thrombosis, it can also be associated with cocaine use. Cardiac chest pain can also be precipitated by anemia, bradycardias (excessively slow heart rate) or tachycardias (excessively fast heart rate).

Development:

Acute Coronary Syndrome is a disease that develops over time stemming from a slow build-up of plaque that is composed of fatty deposits and cholesterol. This massive plaque coating that lines the coronary arteries is called atherosclerosis, and eventually, they prevent the heart from pumping the usual flow of oxygen-infused blood that the rest of the body needs, as well as preventing the heart from receiving the oxygen-rich blood it requires. Chest pain, also known as angina, is one of the primary symptoms of this occurrence.

Acute Coronary Syndrome is one of the signs of coronary heart disease, and it is the direct result of the damage caused by atherosclerosis to the arteries of the heart.

When a coronary artery becomes too clogged with plaque, the artery may rupture, which leads to a heart attack. A Coronary Artery Syndrome usually develops after one such rupture, caused by the inevitable blood clot that results from it, thus blocking the blood flow through the affected artery.

Signs and Symptoms of Acute Coronary Syndrome:

The cardinal sign of decreased blood flow to the heart is chest pain experienced as tightness around the chest and radiating to the left arm and the left angle of the jaw. This may be associated with diaphoresis (sweating), nausea and vomiting, as well as shortness of breath. In many cases, the sensation is "atypical", with pain experienced in different ways or even being completely absent (which is more likely in female patients and those with diabetes). Some may report palpitations, anxiety or a sense of impending doom and a feeling of being acutely ill.

The description of the chest discomfort as a pressure has little utility in aiding a diagnosis as it is not specific for Acute Coronary Syndrome.

Other common ailments that signal the onset of Acute Coronary Syndrome include Q-wave myocardial infarction, non-Q-wave myocardial infarction, non-ST-segment elevation, and unstable angina. These symptoms are considered life threatening, and many people who exhibit them need to be subject to emergency medical attention. This is particularly true as coronary heart disease is responsible for high mortality rates in the United States.

Some or all of these symptoms may occur at the same time and require immediate medical attention, particularly if they are accompanied with a strong hunch that something is seriously wrong with a person's heart.

Diagnosis of Acute Coronary Syndrome:

Electrocardiogram:

There are a variety of ways that the medical community uses to diagnose Acute Coronary Syndrome. One is through the use of an electrocardiogram in the case of acute chest pain. An electrocardiogram measures the extent of heart damage and can be used as a reliable measure of the various causes of chest pain (angina), or to determine whether the patient has had a heart attack. For instance, it can pinpoint acute heart damage, as in the case of elevation in the ST segment, and the cardiologist may recommend treatment via an angioplasty procedure, or thrombolysis.

The doctor will ask further questions about the patient's medical history to ascertain whether the symptoms of Acute Coronary Syndrome are present, and to determine whether the patient has a family history of heart problems, such as stroke, high blood cholesterol, hypertension, coronary artery disease, or related diseases such as diabetes.

Imaging and blood tests:

Another method of diagnosis includes imaging and blood tests to determine the cause of the chest pain. Most hospital emergency rooms provide facilities for chest x-rays, as well as blood tests like myocardial markers, and even a D-dimer if the doctor suspects that the patient is suffering from a pulmonary embolism. The patient may also undergo telemetry, which is the monitoring of the heart rhythm, to determine the exact cause of the symptoms of chest pain.

People at risk of Acute Coronary Syndrome:

People who are at risk for Acute Coronary Syndrome are older adults ranging from the average age of 45 years for men and 55 years for women. Those who have been previously diagnosed with high blood pressure or high blood cholesterol are also at risk, as are smokers, people who have unhealthy eating habits, and those who lead sedentary lifestyles with a marked lack of regular physical activity. People with a family history of angina, stroke and heart disease are likewise at risk, as well as patients who suffer from Type 2 diabetes.

Prevention of Acute Coronary Syndrome:

Acute coronary syndrome often reflects a degree of damage to the coronaries by atherosclerosis. Primary prevention of atherosclerosis is controlling the risk factors: healthy eating, exercise, treatment for hypertension and diabetes, avoiding smoking and controlling cholesterol levels; in patients with significant risk factors, aspirin has been shown to reduce the risk of cardiovascular events. Secondary prevention is discussed in myocardial infarction.

After a ban on smoking in all enclosed public places was introduced in Scotland in March 2006, there was a 17 percent reduction in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers.

Treatment of Acute Coronary Syndrome:

The main goal in the emergency treatment of Acute Coronary Syndrome is to allow the flow of blood to and from the heart to resume at a normal rate as soon as possible. The doctor may order the use of medications that stimulate the normal flow of blood, such as nitroglycerin and heparin. Patients who suffer from angina are generally prescribed pain relievers for chest pain, and are given oxygen to relieve shortness of breath.

The advances in medical techniques today are such that a full recovery is possible for a greater number of people who suffer from Acute Coronary Syndrome. The use of defibrillators is more common, advanced medical equipment is more available in public places, and there are more medical personnel available who know how to use them.

Unfortunately, despite these advances in heart medicine and techniques, people continue to succumb to Acute Coronary Syndrome due to the kind of lifestyle they lead. The lack of regular physical activity, stress, smoking, and unhealthy eating habits are some of the leading causes of Acute Coronary Syndrome mortalities. People can improve their chances of avoiding this ailment if they make more appropriate lifestyle choices, particularly if they fall within the range of risk factors for this disease. This way, they will have a better chance of making a full recovery should they be diagnosed with Acute Coronary Syndrome.