Many Americans suffer from health conditions related to the heart. In fact, coronary artery disease is the leading cause of death in the United States. Diet, lifestyle choices, and the natural effects of aging can all play a role in the development of heart problems. 

Acute coronary syndrome is associated with the development of coronary artery disease and can indicate that a patient is at risk of suffering a heart attack. When diagnosed early, proper medical treatment and management of risk factors can help patients slow or even stop the development of coronary heart disease.

About Acute Coronary Syndrome

Acute coronary syndrome is a term referring to chest pain caused by a reduced flow of oxygen-rich blood to the heart. Blood flow is reduced when arteries become damaged or constricted by the build-up of fatty deposits called plaque in the arteries. Over time, many factors can damage the arteries and encourage the buildup of plaque, including a person’s diet, insufficient exercise, and smoking.

Plaque buildup limits blood flow to the heart, bringing on symptoms of acute coronary syndrome, and causing hardening of the arteries. If the plaque in the coronary arteries ruptures, a blood clot will form, potentially blocking the flow of blood in the artery and causing a heart attack.

Acute coronary syndrome results from an underlying heart condition.  It is important to recognize the risk factors for acute coronary syndrome as well as coronary heart disease.  If you are at an increased risk, early monitoring and a healthy lifestyle can be beneficial in preventing serious complications.  

Risk factors include:

• Age(men over the age of 45 and women over the age of 55)

• High blood pressure

• High levels of cholesterol

• Lack of exercise or physical activity

• Cigarette smoking

• Diabetes

• Unhealthy diet

• Family history of heart disease

Chest pain is a common symptom of acute coronary syndrome. This can be experienced as pressure, tightness, or burning. Additional symptoms can include:

• Pain in the arms, neck, jaw, or back

• Shortness of breath

• Nausea

• Lightheadedness or dizziness

• Weakness

• Abdominal pain

• Clammy skin

• Confusion

You should consult your doctor immediately if you experience any combination of these conditions. If chest pain and accompanying symptoms last for more than a few minutes, dial 911.

When a patient seeks medical attention for chest pain, a doctor will perform a physical examination and ask questions about a patient’s symptoms. The doctor will also request a patient’s family history and lifestyle information to determine if a patient has a heightened risk of heart disease or acute coronary syndrome. Based on this information, additional tests might be performed, including:

• Electrocardiogram (EKG) – A painless, noninvasive test in which electrodes are used to measure and record the electrical activity of the heart. Because injured heart muscle does not conduct electrical impulses properly, an EKG can detect areas that have been damaged, possibly by a heart attack.

• Blood tests – Following a heart attack, damaged heart tissue can leak enzymes into the bloodstream. A blood test can determine the level of these enzymes in the patient’s blood and indicate whether a heart attack has occurred.

• Coronary angiogram – A test that involves injecting liquid dye into the bloodstream through a thin tube called a catheter in the arm or leg. As the dye travels through the arteries, X-ray images allow the doctor to see areas of blockage. 

• Echocardiogram – This test uses sound waves to create an image of the heart.  An echocardiogram can show how well blood flows through the heart, and can detect possible blot clots within the heart.

• Chest X-ray – A chest X-ray allows the doctor to check the size and shape of the heart and blood vessels.

• Nuclear scan – A small amount of radioactive material is injected into the bloodstream. A specialized camera records the flow of the radioactive material as it flows through the heart, identifying areas where blood flow is restricted or reduced.

• Computerized tomography (CT) angiogram – A CT angiogram utilizes radioactive dye along with a CT scanning machine that takes images of the arteries. The images can reveal which arteries are narrowed or blocked.

Based on your doctor’s diagnosis, there are a variety of treatments that may be prescribed.  These include medication, surgery, and changes in lifestyle.  

Changes in lifestyle

When the symptoms of acute coronary syndrome are mild, lifestyle changes may be the only necessary form of treatment. Patients can work with a doctor and dietician to develop a healthy eating plan, make changes in their diet, and to find safe ways to incorporate more exercise into their daily routine. Lifestyle changes may also include losing weight, quitting smoking, or controlling stress levels. 

Medication

There are many medications that can be used to alleviate the symptoms of acute coronary syndrome and prevent more serious complications from occurring.

• Blood thinners – Medications such as aspirin function as blood thinners, which can prevent the formation of blood clots.

• Beta blockers – Beta blockers help control the rhythm of the heart and reduce blood pressure.

• Nitrates – Nitrates such as nitroglycerin serve to temporarily widen blood vessels, improving the flow of blood to the heart.

• Other medications –There are various other medications a doctor can prescribe to help regulate blood pressure, cholesterol, and blood clotting.

Surgical procedures  

When further treatment is necessary to restore normal blood flow to the heart, or when a patient experiences a heart attack or cardiac arrest, surgery may be necessary. Surgical procedures include the following:

• Angioplasty – This surgery is done to widen an artery, restoring blood flow. 

• Stenting – During angioplasty surgery, a surgeon might place a small mesh tube called a stent into the artery to open it and allow blood flow. The stent is left in after surgery to permanently open the artery. 

• Coronary bypass – This is done to create an alternate route for blood flow around an artery that is blocked.

Outlook

Symptoms of acute coronary syndrome should never be overlooked because the condition can be life-threatening. However, early diagnosis and proper medical care can lessen the risk of developing serious complications. And these serious complications can be managed and often even prevented if a patient knows he or she is at risk, monitors blood pressure and cholesterol, eats a heart-healthy diet, and lives a healthy, active lifestyle.