Acute Coronary Syndrome

What is acute coronary syndrome (ACS)?

ACS is sudden decreased blood flow to your heart. This causes a lack of oxygen to your heart and can lead to unstable angina or a heart attack.

What causes ACS?

ACS is caused by narrowing of the blood vessels that carry blood and oxygen to the heart muscle. Unstable angina occurs when part of the artery is blocked, or a clot gets stuck and then breaks free. A heart attack occurs when the narrowed artery becomes totally blocked, usually by a blood clot or plaque.

What increases my risk for ACS?

  • Plaque or platelet buildup in your arteries

  • Personal or family history of coronary artery disease

  • Medical conditions, such as high blood pressure or diabetes

  • Being a woman over 40 years old or man over 33 years old

  • Obesity, smoking, or lack of exercise

What are the signs and symptoms of ACS?

  • Chest pain or discomfort, including squeezing, crushing, pressure, tightness, or heaviness

  • Pain or discomfort in your arms, shoulders, neck, back, or jaw

  • Heartburn, nausea, or vomiting

  • Abdominal pain

  • Shortness of breath

  • Sweating, weakness, or fainting

How is ACS diagnosed?

  • An EKG records the electrical activity of your heart. It is used to check for abnormal heart rhythm.

  • Blood tests are done to look for signs of damage to your heart muscle. These tests will be done more than once.

  • An echocardiogram (echo) is a type of ultrasound that shows the size and shape of your heart. An echo also looks at how your heart moves when it is beating. An echo can show fluid around your heart or problems with your heart valves.

  • A cardiac catheterization is a procedure to check for blockage in your arteries. A tube is threaded to your heart through a blood vessel in your leg or arm. Dye will be injected through the tube to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • A stress test helps caregivers see the changes that take place in your heart while it is under stress. Caregivers may place stress on your heart with exercise or medicine.

Which medicines are used to treat ACS?

  • ACE inhibitors and beta-blockers keep your blood vessels open and help your heart pump strongly and regularly.

  • Cholesterol medicine helps lower the amount of plaque buildup in your arteries. You may also need blood pressure medicine to decrease the strain on your heart.

  • Anticoagulants help keep the blood from clotting and closing partly blocked arteries.

  • Antiplatelets , such as aspirin, keep platelets from sticking to a damaged part of your artery.

  • Thrombolytics help break apart and dissolve clots.

  • Pain medicine may be given to decrease your pain and slow your heart rate.

  • Nitroglycerin opens the arteries to your heart so the heart gets more oxygen. It is given as a pill, IV, or topical patch or paste.

What are some other treatments for ACS?

  • An angioplasty is a procedure to open up an artery blocked by plaque. A tube with a balloon on the end is threaded into the blocked artery. The balloon is filled with liquid, which presses the plaque against the artery wall. This opens the artery so blood can flow through it.

  • Coronary intravascular stent placement is usually done during an angioplasty. A stent is a hollow tube made of wire mesh that is put into a coronary artery. The stent supports the artery and keeps it open so blood can flow through it.

  • Coronary artery bypass graft surgery (CABG) is open-heart surgery. A graft is used from another artery in your body to replace the blocked one.

  • Cardiac rehab is a program that teaches you how to live a more heart-healthy lifestyle, including nutrition and exercise.

How can I help prevent ACS?

  • Eat a variety of healthy, low-fat foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask for more information about a heart healthy diet.

  • Exercise regularly. Ask your caregiver about the best exercise plan for you.

  • Maintain a healthy weight. Ask your caregiver how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

  • Do not smoke. If you smoke, it is never too late to quit. Ask your caregiver for information if you need help quitting.

When should I contact my caregiver?

Contact your caregiver if:

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if you have any of the following signs or symptoms of a heart attack:

  • Squeezing, pressure, fullness, or pain in your chest that lasts longer than a few minutes or returns

  • Discomfort or pain in your back, neck, jaw, stomach, or arm

  • Shortness of breath or breathing problems

  • A sudden cold sweat, lightheadedness, dizziness, or nausea, especially with chest pain or trouble breathing

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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