Acute coronary syndrome (ACS)

2021-08-01 02:51 PM

Many acute coronary syndromes have symptoms similar to those of a heart attack. If the acute coronary syndrome is not treated quickly, a heart attack will occur.

Define

The acute coronary syndrome is a term used when there is a sudden decrease in blood flow to the heart. The acute coronary syndrome can describe chest pain during a heart attack or chest pain at rest or from physical activity. Acute coronary syndromes are usually diagnosed in the emergency room or hospital.

Acute coronary syndromes are curable if diagnosed quickly. Treatments for acute coronary syndromes vary, depending on your signs, symptoms, and health status.

Symptoms

Many acute coronary syndromes have symptoms similar to those of a heart attack. And if the acute coronary syndrome is not treated quickly, a heart attack will occur. Importantly, identifying acute coronary syndrome symptoms is very serious.

Get medical help right away if you have signs and symptoms and think you're having a heart attack

Chest pain (angina) that feels like squeezing, pressure, or tightness and lasts a few minutes or longer, can occur with exercise, emotional stress, or eating a large meal.

Pain elsewhere in the body, such as the upper arm or jaw.

Nausea.

Vomiting.

Shortness of breath.

Sudden heavy sweating.

Shocked.

If you are having a heart attack, the signs and symptoms may be different for women.

For women often symptoms include

Abdominal pain or pain similar to heartburn.

Skin moist.

Dizziness or dizziness

Unusual or unexplained fatigue.

If you have chest pain and believe it is an emergency, seek medical help immediately whenever possible, get emergency medical assistance rather than driving yourself to the hospital. hospital - could be more serious.

If you have period pain, see your doctor. It can be a form of angina, and your doctor can help decide on the best treatment.

Causes

The acute coronary syndrome can develop slowly over time by the formation and growth of plaque in the arteries in the heart. These plaques, made up of cholesterol, narrow the lumen of the arteries and make it harder for blood to flow through them. This buildup of plaque is called atherosclerosis. Ultimately, this buildup can prevent the heart from pumping enough oxygen-rich blood to the rest of the body, causing chest pain (angina) or a heart attack.

One medical term associated with the acute coronary syndrome is coronary artery disease. Coronary artery disease refers to damage to the arteries of the heart with atherosclerosis.

If one of the plaques in a coronary artery ruptures, it can cause a heart attack. In fact, many cases of coronary syndrome develop after plaque rupture. A blood clot will form due to the rupture of the plaque, blocking the flow of blood.

Risk factors

The risk factors for the acute coronary syndrome are similar to those for other types of heart disease.

Risk factors for acute coronary syndromes include:

Advanced age (over 45 for men and over 55 for women).

Hypertension.

High cholesterol in the blood.

Smoking.

Lack of physical activity.

Type 2 diabetes.

Family history of chest pain, heart attack, or stroke

Preparations for medical examination

The acute coronary syndrome is usually diagnosed in emergency situations, and your doctor will perform a number of tests to find the cause of your symptoms. Your doctor will talk during this process and tell you what tests need to be done.

If chest pain is frequent, tell your doctor. Your doctor will likely order some tests to find the cause of your chest pain. These tests may include checking cholesterol and blood sugar levels. If these tests are needed, an empty stomach will be needed for about 9 to 12 hours to get the most accurate results.

Your doctor may also want to perform an imaging test to see if your heart and blood vessels leading to it are blocked.

Tests and diagnostics

If you have signs and symptoms of the acute coronary syndrome, your doctor may recommend some tests to see if your symptoms are caused by a heart attack or another form of chest pain.

If your doctor thinks you're having a heart attack, the first two checks are:

Electrocardiogram (ECG): This is the first test done to diagnose a heart attack. It is usually done while asking about symptoms. This test records the electrical activity of the heart through electrodes attached to the skin. The recorded pulse is the "wave" displayed on a screen or printed on paper. Because the injured heart muscle does not show normal electrical impulses, an ECG may show that a heart attack has occurred or is in progress.

Blood tests: Certain enzymes from the heart leak into the bloodstream if the heart is damaged by a heart attack. Emergency personnel will take a blood sample to check for the presence of these enzymes.

Your doctor will review the test results and determine the severity of your condition. If the blood test results show no signs of a heart attack and chest pain is another cause, tests may still be done to check blood flow through the heart. If the test results show that you have had a heart attack or maybe at high risk of having a heart attack, you may be admitted to the hospital. Then there may be further tests, such as coronary angiography.

Your doctor may also order additional testing, either to find out if your heart has been damaged by a heart attack, or if symptoms point to a cause:

Echocardiography. If the doctor determines that there is no heart attack and the risk of heart attack is low, it is likely that an echocardiogram will be ordered before leaving the hospital. This test uses sound waves to create images of the heart. In an echocardiogram, sound waves are directed at the heart from a transducer. An echocardiogram can help identify an area of ​​the heart muscle that has been damaged by a heart attack and the pumping function of the heart.

Chest X-ray. Chest X-ray images allow your doctor to check the size and shape of your heart and its blood vessels.

Nuclear scan: This test helps identify problems with blood flow to the heart. A small amount of radioactive material, such as thallium, is injected into a blood vessel. Special cameras can detect radioactive material as it flows through the heart and lungs.

Computed tomography (CT) scan. CT allows your doctor to examine your artery to see if it's narrowed or blocked. You will be injected with radioactive dye, and a CT machine will create images of the arteries in your heart. These images are then sent to a computer screen for doctors to view. This test is usually only done if blood tests and an electrocardiogram do not indicate the cause of the symptoms.

Cardiac catheterization. This test can show narrowed or blocked coronary arteries. A dye is injected into an artery through a catheter, usually in the leg. When filled with arterial staining, the artery becomes visible on radiographs and indicates areas of obstruction. Also, while the catheter is in place, the doctor can treat the blockage by performing angioplasty. Angioplasty is the use of a small balloon through a blood vessel and into a coronary artery to widen the blocked area. In most cases, a mesh tube (stent) is also placed inside the artery to keep it wide open and prevent future re-narrowing.

Treatments and drugs

Treatment of acute coronary syndromes varies, depending on the symptoms and how well the occlusion is counteracted.

Medicine

Your doctor will recommend medication that can relieve chest pain and improve flow through the heart. May include:

Aspirin: Aspirin reduces blood clotting, making it easier for blood to flow through narrowed heart arteries. Aspirin is one of the first things that may come up in the emergency room when the acute coronary syndrome is suspected. Chewing aspirin may be required as it is absorbed into the bloodstream more quickly. If your doctor diagnoses symptoms of the acute coronary syndrome, then daily aspirin therapy may be recommended.

Anticoagulants and thrombolytics: These drugs, also known as clot busters, help dissolve blood clots that block blood flow to the heart. If you're having a heart attack and have previously taken thrombolytics, it may help and reduce damage to your heart.

Nitroglycerin: This medication for chest pain and angina is intended to temporarily widen the narrowing of blood vessels, improving blood flow to and from the heart.

Beta-blockers: These drugs relax the heart muscle, slow the heart rate and lower blood pressure, and reduce myocardial oxygen demand. These drugs can increase blood flow through the heart, reduce chest pain, and potentially damage the heart muscle during a heart attack.

ACE inhibitors and angiotensin receptor blockers (ARBS): These drugs allow blood to flow more easily. Your doctor may prescribe an ACE inhibitor or ARBS if you've had a moderate to severe heart attack and reduced the heart's pumping ability. These drugs also lower blood pressure and may prevent a second heart attack.

Surgery and other procedures

If medication isn't enough to restore blood flow through the heart, your doctor may recommend one of these procedures:

Angioplasty and stenting. The deflated balloon is passed through the catheter into the narrowing area, then the balloon is inflated. A mesh tube (stent) is usually left in the artery to help keep the artery open. Angioplasty can also be performed with laser technology.

Coronary surgery. The blocked part of an artery in the heart does not circulate, and an artery from another part of the body, like the leg, takes its place.

Lifestyle and remedies

Steps can be taken to prevent acute coronary syndrome or improve symptoms.

No smoking. The single most important thing you can do to improve your heart health is to quit smoking. Talk to your doctor if you're having trouble quitting.

Eat a heart-healthy diet: Too much-saturated fat and cholesterol in your diet can narrow your heart's arteries. Follow your doctor's and dietitian's recommendations for a heart-healthy diet that includes plenty of whole grains, lean meats, low-fat dairy, and fruits and vegetables. Also, consider your daily salt and fat intake. Eating too much salt and saturated fat raises blood pressure and cholesterol.

Exercise regularly. Regular exercise improves heart muscle function and keeps blood flowing through the arteries better. It may also reduce the risk of acute coronary syndrome by achieving and maintaining a healthy weight and controlling diabetes, high cholesterol, and high blood pressure. Exercise is not vigorous. For example, walking 30 minutes a day, five days a week can improve health.

Check cholesterol. Blood cholesterol levels are checked regularly through blood tests. If cholesterol levels are at risk, your doctor may prescribe them with dietary changes and medications to help lower numbers and protect heart health.

Control blood pressure. Blood pressure is checked at least every two years. Your doctor may recommend more frequent checkups if you have high blood pressure or a history of heart disease.

Maintain a healthy weight. Excess weight can contribute to high cholesterol, high blood pressure, and diabetes. Weight loss can reduce the risk of acute coronary syndromes.

Reduce stress. To reduce your risk of heart attack, reduce the stress of daily activities. Review your workaholic habits and find healthy ways to minimize or cope with stressful life events.

Drink alcohol in moderation. Drinking more than 1-2 glasses of alcohol a day raises blood pressure, so cut back if necessary. From a heart health standpoint, men and women can have one glass of wine a day for heart health. Drinking is equivalent to 355 ml of beer, 118 ml of wine, or 44 ml of spirits.

Prevention

The same lifestyle changes that help reduce symptoms of ACS can also help prevent it from happening. Eat healthily, exercise most days of the week for 30 to 60 minutes, regularly check your blood pressure and cholesterol levels.