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Acute Coronary Syndrome


Acute coronary syndrome (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.


Call 911 for any of the following 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

Contact your healthcare provider if:

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

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.


You may need any of the following:

  • 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.
  • Blood pressure medicine helps decrease the strain on your heart.
  • Pain medicine helps decrease your pain and slows your heart rate.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Attend cardiac rehab:

Cardiac rehab is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. This plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Healthcare providers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Eat 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.


Your healthcare provider will tell you which activities to limit or avoid. Ask when you can drive, return to work, and have sex. Ask about the best exercise plan for you.

Maintain a healthy weight:

Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

Do not smoke:

Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Get the flu and pneumonia vaccines:

All adults should get the influenza (flu) vaccine. Get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older. The vaccine is given every 5 years to prevent pneumococcal disease, such as pneumonia.

© 2016 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.

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.