An acute coronary syndrome (ACS) is a broad term referring to a spectrum of conditions where there is a sudden reduction or blockage of the blood flow in the heart. When the heart muscle does not receive enough blood, it malfunctions or is damaged, causing harm to the body. Heart attacks, a health condition we all are familiar with, are acute coronary syndrome.
Cause of Acute Coronary Syndrome
Acute Coronary Syndrome is caused due to the presence of plaque, a fatty substance that gets built up in the arteries. They get settled either in or on the arteries or the blood vessels that carry oxygen to the body. The moment the plaque ruptures, it forms a blood clot that prevents blood flow. As a result, the blood is restricted from flowing to its destination, causing a lack of oxygen that kills the heart muscle.
Lack of oxygen to the heart muscle, as mentioned earlier, will kill the heart cells that will eventually result in myocardial infarction, commonly known as a heart attack. Or at the least, lack of oxygen might damage the cells causing temporary discomforts that eventually lead to unstable angina.
We will explore types of acute coronary syndrome to understand the health condition.
Types of Acute Coronary Syndrome
1. Unstable Angina
It is a chest discomfort caused due to the insufficient flow of blood to the heart muscles. It is a painful discomfort that can eventually lead to a heart attack. Immediate treatment and early intervention are significant. Having unstable angina might pose the chances of getting a heart attack in a few days or weeks. Hence treatment again is essential at the earliest.
Unstable angina doesn’t have a predictable pattern. Due to acute stress, it might happen suddenly during mild physical activities, at rest, or even during sleep.
a) Symptoms of Unstable Angina
- Shortness of breath
- Eeling Nauseous or weak
- Pain in the left arm, neck, or back
- Chest ache
b) How is Unstable Angina Diagnosed?
As mentioned earlier, unstable angina is an acute coronary syndrome that needs to be paid attention to immediately. These are some ways in which it is diagnosed.
- Coronary Angiography
c) How Long Does Unstable Angina Last?
An episode of unstable angina might last for about 15 to 20 minutes or more.
The episode might be controlled with treatment, but one might be vulnerable to multiple episodes in the absence of treatment. Hence, unstable angina should be taken as a strong warning for other heart-related health risks.
2. Non-ST-Elevation Myocardial Infarction (NSTEMI)
NSTEMI is an abbreviation for non-ST-elevation myocardial infarction. This form of heart attack is less damaging to the body. This occurs when the body is unable to meet the need for sufficient oxygen. This gets named after STEMI, where the electrical patterns are identifiable, but in NSTEMI, they don’t have an identifiable electrical pattern. As with any other heart attack, the heart muscle gets affected due to a lack of blood flow that needs immediate medical attention. No heart attack must be left unattended.
NSTEMI is very common in the west, especially in the United States. More than 7 Lakh individuals show acute coronary syndrome, of which 70 % show NSTEMI, that is around five and a half lakh of the affected ones.
a) Symptoms of NSTEMI
- Shortness of breath
- Heavy breathing
- Chest Pain
- Stomach discomfort
- Pain in the neck, shoulder, arms, back, and belly.
- Tightness in the chest
b) How is NSTEMI Diagnosed?
This acute coronary syndrome is diagnosed by a physician through the use of multiple tests and methods. They first gather all necessary information before analyzing and coming to a conclusion. This is extremely important as most heart attacks are similar to each other yet significantly different, including various types of testing that reduce the chances of misdiagnosis.
The blood tests are done to check the level of troponin I, creatine kinase-myocardial band (CK-MB), and troponin T. Their levels will indicate the typical damage done to the heart cells. However, it is important to note that blood tests alone cannot confirm the disorder or health issue.
2. Electrocardiogram (EKG or ECG)
It is another type of test that records and reflects the electrical signals it receives from the heart. The test involves attaching small electrodes to the individual’s chest, arms, and or legs. The electrodes are connected to the ECG system via wires. The information thus generated is analyzed. Only trained medical professionals can diagnose accurately.
Many people think that electricity is sent to the body, but this is a myth. There is no need for special preparation, such as going for the test with an empty stomach to get the test conducted.
If the above tests did not provide sufficient information or evidence, imaging is carried out. It includes the following:
1. Computed Tomography (CT) Scan
A set of X-rays or 3-dimensional images are used to study the heart. A substance is injected into the body so that it clearly reflects the health condition through X-rays.
The test detects and reflects the presence of any plaques in the arteries that might potentially pose the risk of a heart attack. However, research proves that X-rays entering the body might harm the DNA. Nevertheless, CT scans are not done too many times, which means the exposure of X-rays to the body will not cause any severe damage.
2. Cardiac Magnetic Resonance Imaging (MRI)
It is a non-invasive assessment that uses magnetic scanners and computer processors that give detailed images of the heart.
This assessment uses ultra-high-frequency sound waves that produce detailed images of the heart. This is often used in emergency situations, as it is easily portable.
All the above methods are used by health care providers to diagnose the condition accurately.
3. ST-Elevation Myocardial Infarction (STEMI)
The third form of acute coronary syndrome is ST-elevation myocardial infarction (STEMI), another type of heart attack that affects the heart’s lower chambers. This heart attack is more severe in comparison to the rest. A distinct electrical pattern through ECG is observed in this form of myocardial infarction.
a) What Causes ST-Elevation Myocardial Infarction (STEMI)?
This acute coronary syndrome is caused when there is a blockage in the flow of blood to the heart muscle. As mentioned earlier, this makes the heart muscle deficient in oxygen, that in turn damages and fails the muscle.
b) Types of STEMI
There are three coronary arteries in the body. Types of STEMI are named depending on which coronary artery is damaged or blocked.
1. Inferior or Lateral STEMI
Here, the coronary on the right side that provides blood to the bottom side of the heart is affected, or the LCX, the left circumflex that produces blood to the side wall of the heart, is affected. These are, however, less serious than the upcoming ones.
2. Anterior STEMI
When the blockage has occurred on the left anterior descending (LAD) artery, the STEMI is called Anterior STEMI. This is the largest artery and is responsible for supplying blood to the front side of the heart. Since it is responsible for producing blood for most parts of the heart, its damages are much more significant.
Investing in a Healthy Lifestyle
Acute coronary syndromes can be avoided by practicing a simple healthy lifestyle. A healthy lifestyle can reduce cardiovascular risk and restore blood flow through good exercise. Coronary heart disease is not inevitable. They can be treated if handled with care. In addition to clinical medicine usage of blood thinners, one can manage health conditions through a healthy lifestyle.
Exercise in any form, yoga, running, swimming, and much more, can lower the risk of heart disease. Get moving each day. You do not have to have a gym set up to work out. One can simply walk for a few minutes. Having proper physical activities is also going to help you control your weight. Do not rush or over-burden yourself by exercising intensively all of a sudden. Rather take it slow, enjoy the process, and slowly reap the benefits. No matter how busy you get through the day, take some time to move your body healthily.
2. Healthy Diet
Having a healthy diet is key to a healthy lifestyle. Regardless of having acute coronary syndrome, one must consume sufficient healthy food to take good care of the body. Avoid food with high cholesterol. Do remember that a good amount of cholesterol is needed for the body, so try and consume food that gives a good form of cholesterol, like eggs. Consume fresh fruits, vegetables, beans, legumes, and whole grains, and as mentioned earlier, focus on healthy fats. Get your fats from fish, eggs, avocado, olive oil, and other similar foods. Consume low-fat or fat-free dairy products as much as possible and avoid consuming highly processed foods that are nutrient deficient and high in calories.
3. Reduce your Stress
Research shows that stress potentially poses heart risks. Stress also leads individuals to come up with unhealthy means of coping. Stress is inevitable in the life we live; hence, what is more, important is that we learn to manage our stress so that we don’t end up over-eating, feeling anxious, or restless.
4. Quit Smoking
Second, smoking in itself poses harm to individuals, so think of what first-hand smoking can do. The chemicals in a cigarette can potentially increase blood pressure and heart rate and damage the heart and blood muscles. This will reduce the blood flow and, in turn, oxygen supply to the blood muscles. If you are already a smoker, then make conscious changes to your lifestyle. Start by reducing the number of cigarettes you consume in a day and focus on completely eliminating them in the near future.
5. Quality Sleep
Other than these major changes, one must also focus on getting quality sleep. Rest is essential to the human body. And, getting a good amount of sleep will help both your physical and mental health. Hence, good sleep must also be your priority.
6. Maintain your Weight
One must also focus on maintaining their weight. Being overweight may increase the risk of heart issues. Be mindful of your weight. Consuming a healthy diet and exercising regularly will help us eliminate this problem.
Treatment for Acute Coronary Syndrome
The acute coronary syndrome is first treated with medicines depending on the diagnosis. Some medications include:
They reduce the heat rate of the body, thereby reducing its oxygen demand. This helps the body compromise the lack of oxygen supply to the muscle. Corgard and Lopressor are some examples of the same that help acute coronary syndrome.
Statins block the production of cholesterol in the liver, thereby reducing the cholesterol levels in the blood. Cholesterol is what obstructs the arteries. Hence this medication helps the acute coronary syndrome significantly.
This medication acts as a vasodilating medicine that widens the blood vessels, thereby allowing a better flow of blood to the heart muscles, which could avoid acute coronary syndromes.
There are several other medications used to treat acute coronary syndrome; these are just a few on the list.
2. Medical Procedures (Surgery)
As a last resort, the doctors might advise a Coronary bypass surgery or an angioplasty and stenting procedure to immediately treat the body from acute coronary syndromes. Bypass surgery involves grafting a blood vessel from one part of the body to another, creating an entirely new route for the heart muscle to receive sufficient blood.
Angioplasty and stenting is a procedure that involves inserting a catheter along the tube into the blocked arteries. A deflated balloon is then passed into the catheter, which, when inflated, widens the artery and compresses the plaque deposit. In addition, a stent, a mesh-like structure, is left in the artery to keep the artery widened.
Side-by-side therapy is also needed for patients with the acute coronary syndrome. The symptoms can be treated if detected earlier. This is a very curable health condition. We must only treat it right and treat it as early as possible. A healthy lifestyle, in addition to the health discomfort, will also aid in the treatment. Regardless, a healthy lifestyle will also help prevent health concerns in the first place.
While at times contributed by guest authors, our content is medically reviewed periodically by professionals for accuracy and relevance. We pride ourselves on our high-quality content and strive towards offering expertise while being authoritative. Our reviewers include doctors, nurses, mental health professionals, and even medical students.
Do note that any information found on the site does not constitute legal or medical advice. Should you face health issues, please visit your doctor to get yourself diagnosed. Icy Health offers expert opinions and advice for informational purposes only. This is not a substitute for professional medical advice.