Overview

Diagnosis of Acute Coronary Syndrome

Acute coronary syndrome (ACS) is a medical emergency that requires immediate attention and testing at a hospital. Your healthcare team will quickly evaluate your symptoms, review your medical history, and perform several heart tests to determine the cause of chest pain or other warning signs.

Common Diagnostic Tests

1. Electrocardiogram (ECG or EKG):
This quick and painless test checks the electrical activity of your heart. Sticky sensors are placed on your chest, arms, or legs to record your heartbeat pattern. Abnormal results may show that your heart isn’t working properly or help identify blocked arteries.

2. Blood Tests:
After a heart attack, damaged heart cells release specific proteins into the bloodstream. Blood tests can detect these markers, helping doctors confirm heart injury.

3. Coronary Angiogram:
This imaging test identifies blockages in the heart arteries. A flexible tube (catheter) is inserted through a blood vessel in the wrist or groin and guided to the heart. A dye is injected to make arteries visible on X-ray images. Sometimes, treatment can be performed during the same procedure.

4. Echocardiogram:
An echocardiogram uses sound waves to create real-time images of your heart. It helps determine how well your heart chambers and valves are functioning and whether your heart is pumping efficiently.

5. Myocardial Perfusion Imaging (Nuclear Stress Test):
A safe radioactive tracer is injected into a vein to visualize blood flow in the heart muscle. This test detects areas with reduced blood supply or previous damage.

6. CT Angiogram:
This noninvasive test uses advanced X-ray technology to create detailed 3D images of your heart and coronary arteries, helping detect plaque buildup or narrowing.

7. Exercise Stress Test:
During this test, you walk on a treadmill or pedal a stationary bike while your heart rhythm and blood pressure are monitored. It shows how well your heart performs under physical stress. If you can’t exercise, medication may be used to simulate the effect of exercise.

After reviewing your symptoms, ECG, and blood test results, your healthcare provider can confirm whether you have acute coronary syndrome, unstable angina, or a heart attack.
Further testing may be done to rule out other causes of chest discomfort and determine the most effective treatment plan.

❤️ Treatment

The primary goals of acute coronary syndrome treatment are to:

  • Relieve pain and stabilize the patient

  • Restore blood flow to the heart as quickly as possible

  • Prevent further heart damage and future complications

Immediate and Long-Term Treatment Goals

Immediate goals:

  • Ease chest pain and shortness of breath

  • Improve oxygen and blood flow

  • Restore normal heart rhythm

Long-term goals:

  • Strengthen heart function

  • Manage underlying risk factors (such as cholesterol and blood pressure)

  • Reduce the risk of another heart attack

Medications for Acute Coronary Syndrome

Depending on your diagnosis and condition, your healthcare provider may prescribe one or more of the following:

  • Clot-busting drugs (Thrombolytics): Dissolve blood clots that block heart arteries.

  • Nitroglycerin: Widens blood vessels to increase blood flow and reduce chest pain.

  • Antiplatelet agents: Help prevent new blood clots. Examples include aspirin, clopidogrel (Plavix), and prasugrel (Effient).

  • Beta-blockers: Lower heart rate and blood pressure to decrease the heart’s workload (metoprolol, nadolol).

  • ACE inhibitors: Relax blood vessels and improve blood flow (lisinopril, benazepril).

  • ARBs (Angiotensin II receptor blockers): Control blood pressure and reduce strain on the heart (losartan, irbesartan).

  • Statins: Lower cholesterol and stabilize plaque buildup (atorvastatin, simvastatin).

  • Other cholesterol-lowering agents: Such as ezetimibe (Zetia) for additional lipid control.

Heart Procedures and Surgical Options

In some cases, procedures or surgery are required to restore proper blood flow to the heart:

1. Angioplasty and Stenting

A thin catheter with a balloon tip is inserted into a blocked artery. The balloon is inflated to open the artery and improve blood flow. Often, a small mesh tube called a stent is placed to keep the artery open permanently.

2. Coronary Artery Bypass Grafting (CABG)

Also known as “bypass surgery,” this procedure uses a healthy blood vessel (usually from the leg or chest) to create a new path for blood flow around a blocked artery. CABG is typically used when multiple arteries are severely blocked.

Recovery and Prevention

  • Take prescribed medications regularly.

  • Follow a heart-healthy diet and maintain a healthy weight.

  • Engage in regular physical activity as advised by your doctor.

  • Quit smoking and limit alcohol consumption.

  • Schedule regular follow-ups for blood pressure, cholesterol, and heart function monitoring.

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