Acute Coronary Syndrome - Symptoms, Causes, Risk, Diagnosis, and Treatment

Introduction

The acute coronary syndrome is a clinical condition characterized by a group of diseases associated with sudden, decreased blood flow to the heart. Myocardial infarction (heart attack) is one condition in which death or destruction of the heart cells occurs. Although this condition might not always cause a heart attack, it can affect the heart tissues.

What Are the Symptoms of Acute Coronary Syndrome?

The signs and symptoms of the acute coronary syndrome are as mentioned below:

• Angina (chest pain) or discomfort. It can feel like aching, tightness, pressure, or burning.

• Vomiting.

• Indigestion.

• Spread of pain from the chest to the arms, shoulders, upper abdomen, back, neck, or jaw.

• Nausea.

• Dyspnea (shortness of breath).

• Diaphoresis is characterized by sudden, heavy sweating.

• Lightheadedness, fainting, or dizziness.

• Unexplained tiredness.

• Apprehensive or feeling restless.

What Are the Causes of Acute Coronary Syndrome?

The main etiology behind acute coronary syndrome is the accumulation of fatty deposits, also called plaques, in and on the walls of coronary arteries. Coronary arteries are the blood vessels that deliver oxygen and nutrients to the heart muscles. A blood clot forms in case of a rupture of a plaque. This clot tends to block the blood flow to the heart muscles. In case of a low supply of oxygen to cells, the cells tend to die. This cell death results in muscle tissue damage and is a heart attack. Even if there is no cell death, the muscles are affected due to low oxygen. This type of change can be temporary or permanent. When acute coronary syndrome does not cause cell death, it is termed unstable angina.

Are There Any Risk Factors?

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

Following are the risk factors for the acute coronary syndrome:

• Aging.

• Cigarette smoking.

• High blood pressure.

• Lack of physical activity.

• Unhealthy diet.

• Obesity.

• Diabetes.

• High blood cholesterol.

• Hereditary (family history of heart disease, chest pain, or stroke).

• History of high blood pressure, diabetes during pregnancy, or preeclampsia.

• COVID-19 infection.

How Can It Be Diagnosed?

You will be assessed for the signs and symptoms based on certain questions. If you have been suspected of this condition, an emergency physician will examine you and order certain tests.

These tests are as follows:

• Electrocardiogram (ECG).

• Blood Tests help analyze certain enzymes in the blood that are observed when cell death has caused damage to heart tissues. A positive enzyme result denotes a heart attack.

Apart from the above tests, the physician may ask you to undergo the following tests to confirm the diagnosis:

• Coronary Angiogram: This procedure utilizes X-ray imaging to visualize the heart's blood vessels.

• Echocardiogram: Sound waves are used in this test which is directed at the heart, and a live image of the heart is produced.

• Computerized Tomography (CT) Angiogram: Specialized X-ray technology is utilized in this test to produce multiple images of the heart in a 2-D cross-section.

• Stress Test: This test reveals the functioning of the heart while exercising.

• Myocardial Perfusion Imaging: This test is used to assess the blood flow through the heart muscle

How Can It Be Treated?

The main goals of treatment for the acute coronary syndrome are as follows:

• Improving the blood flow to the heart muscles.

• Relieving pain and distress.

• Restoring the function of the heart as quickly and as best as possible.

The long-term management goals are to improve the overall functioning of the heart, manage risk factors and decrease the risk of getting a heart attack. Surgery and medications can be used to achieve these goals.

Medications

The medications may be prescribed based on the diagnosis. Thus, it can be for emergency care or maintenance. They are as mentioned below:

• Thrombolytics help in dissolving a blood clot.

• Nitroglycerin helps in improving blood flow.

• Antiplatelet drugs help in preventing blood clot formation.

• Beta-blockers help in relaxing the heart muscles and lower the heart rate.

• Angiotensin-converting enzyme (ACE) inhibitors widen the blood vessels and help improve the blood flow.

• Angiotensin receptor blockers (ARBs) help in controlling blood pressure.

• Statins help lower the amount of cholesterol moving in the bloodstream. It also helps stabilize the plaque deposits, thus decreasing the chances of rupture.

Surgery

The physician can recommend any one of the below-mentioned procedures to restore blood flow to the heart muscles:

Angioplasty and Stenting: In this procedure, the physician inserts a long, tiny tube into the blocked or narrowed part of the artery and may inflate it to widen it.

Coronary Bypass Surgery: This procedure helps create a new route for blood around a blocked coronary artery.

Are There Any Home Remedies?

A healthy lifestyle change is very important to prevent heart attacks.

The following recommendations can be helpful:

• Avoid smoking.

• Eat a heart-healthy diet. You can consume a diet containing fruits and vegetables, whole grains, and moderate amounts of low-fat dairy and lean meats.

• Do exercise regularly.

• Keep a check on your cholesterol levels.

• Maintain your blood pressure. You should check your blood pressure regularly and maintain it with lifestyle changes and medications if required.

• Try to maintain a healthy weight. Increased weight strains the heart and can increase cholesterol levels, diabetes, high blood pressure, heart disease, and other conditions.

• Reduce stress. You can reduce stress by performing yoga. Also, try to reduce stress in your day-to-day life activities.

• Avoid or drink alcohol in moderation. Drinking alcohol can increase blood pressure and, thus, can increase the risk of developing acute coronary syndrome.

Conclusion

Acute coronary syndrome affects the blood supply to the heart muscles and, thus, weakens or stops the functioning of the heart. Thus immediate professional attention is required. It can be diagnosed through various methods such as blood tests and ECG. Eating a healthy diet and exercising regularly helps lower the risk of the acute coronary syndrome.