ACS
Acute Coronary Syndrome (ACS) is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. The syndrome encompasses a variety of clinical presentations, including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. These conditions are considered medical emergencies, as they indicate that the heart muscle is not receiving enough oxygen-rich blood, which can lead to heart muscle damage or death.
Causes
ACS is primarily caused by the rupture of an atherosclerotic plaque within a coronary artery. This leads to the formation of a blood clot (thrombosis) that can partially or completely block blood flow through the coronary artery. Risk factors for ACS include smoking, high blood pressure, high cholesterol, diabetes, obesity, and a sedentary lifestyle.
Symptoms
Common symptoms of ACS include chest pain or discomfort, which may radiate to the arms, shoulder, neck, teeth, jaw, or back. Other symptoms may include shortness of breath, nausea, vomiting, sweating, and dizziness. The symptoms of ACS can vary significantly between individuals, and some people, especially women, the elderly, and people with diabetes, may experience atypical symptoms.
Diagnosis
The diagnosis of ACS involves a combination of medical history, physical examination, electrocardiogram (ECG), and blood tests to measure cardiac biomarkers (such as troponin). An electrocardiogram can help distinguish between STEMI and NSTEMI or unstable angina. Imaging studies, such as coronary angiography, may also be used to visualize blockages in the coronary arteries.
Treatment
Treatment for ACS aims to restore blood flow to the heart muscle and may include medications, such as antiplatelet drugs, beta-blockers, ACE inhibitors, and statins, as well as procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The choice of treatment depends on the type of ACS, the severity of symptoms, and the presence of other medical conditions.
Prevention
Prevention of ACS involves managing risk factors through lifestyle changes, such as quitting smoking, eating a healthy diet, exercising regularly, and maintaining a healthy weight. Medications may also be prescribed to manage conditions like high blood pressure, high cholesterol, and diabetes.
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Contributors: Prab R. Tumpati, MD