Last Updated on March 19, 2025 by Analgesia team
Acute Coronary Syndrome in Medical
ACS stands for acute coronary syndrome, a medical emergency that occurs when blood flow to the heart is suddenly reduced or stopped. ACS is a type of coronary heart disease (CHD) and includes conditions such as unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST elevation myocardial infarction (NSTEMI).
Acute Coronary Syndrome is caused by a blockage in the coronary arteries, usually caused by a blood clot. The blockage can be sudden and complete and can damage the heart muscle.
Types of ACS:
- Unstable Angina: A type of ACS where blood flow is reduced, but not completely blocked, causing chest pain or discomfort.
- Myocardial Infarction (Heart Attack): A more severe form of ACS where blood flow is completely blocked, leading to damage or death of heart muscle tissue.
- ST-segment elevation myocardial infarction (STEMI): A type of heart attack characterized by a specific ECG change (ST-segment elevation).
- Non-ST-segment elevation myocardial infarction (NSTEMI): A type of heart attack where there is no ST-segment elevation on the ECG.
Symptoms of ACS include:
Chest pain or discomfort is common but can vary depending on age, sex, and other medical conditions. Women, older adults, and people with diabetes are more likely to experience symptoms without chest pain.
Prompt treatment can reopen the arteries and restore blood flow to the heart. Lifestyle changes and medication can help prevent or treat Acute Coronary Syndrome.
How ACS is diagnosed
Acute Coronary Syndrome (ACS) is diagnosed through a combination of clinical evaluation, diagnostic tests, and imaging. Here’s an overview of the key steps involved:
1. Clinical Evaluation
- Symptoms: Doctors assess symptoms like chest pain, shortness of breath, nausea, sweating, or pain radiating to the arms, back, or jaw.
- Medical History: A detailed history of the patient’s health, lifestyle, and risk factors (e.g., smoking, high blood pressure, diabetes) is taken.
2. Electrocardiogram (ECG)
- An ECG is performed within minutes of suspected ACS. It measures the heart’s electrical activity and helps identify:
- ST-Elevation Myocardial Infarction (STEMI): Persistent ST-segment elevation indicates a complete coronary artery blockage.
- Non-ST-Elevation Myocardial Infarction (NSTEMI) or Unstable Angina: These may show subtle or no changes on the ECG.
3. Blood Tests
- Cardiac Biomarkers: Blood tests measure proteins like troponin, which are released when the heart muscle is damaged. Elevated troponin levels confirm myocardial injury.
- Other markers, such as creatine kinase-MB (CK-MB), may also be assessed.
4. Imaging Tests
- Echocardiogram: Echocardiogram uses ultrasound to visualize the heart and assess its function.
- Coronary Angiography: A more invasive test that uses contrast dye and X-rays to identify blockages in the coronary arteries.
5. Risk Assessment Tools
- Tools like the GRACE score are used to evaluate the severity of ACS and guide treatment decisions.
These diagnostic steps help doctors determine the type of ACS (STEMI, NSTEMI, or unstable angina) and plan the most effective treatment.