The medical term that describes multiple conditions that cause decreased blood flow to the heart is acute coronary syndrome. These include myocardial infarction, unstable angina, and others.
While a heart attack (myocardial infarction) happens when the death of the cells causes damage to the heart tissue, unstable angina often occurs when blood flow to the heart is reduced. However, the second condition is less severe and does not cause cell death or a myocardial infarction, but reduced blood flow to the heart muscle significantly elevates the risk of a heart attack.
The most common symptom of acute coronary syndrome is severe chest pain. Without immediate treatment, it may lead to death. The goal of the treatment is to restore blood flow to the heart and prevent life-threatening complications.
Symptoms
In most cases, the symptoms of this syndrome happen suddenly. Check below some symptoms:
- Chest pain (also called angina) or discomfort
- Pain that begins in the chest and spreads to other parts of the body, including the shoulders, arms, upper abdominal area, back, neck, or jaw
- Nausea
- Vomiting
- Indigestion
- Shortness of breath (also known as dyspnea)
- Sudden sweating
- Fast heart rate
- Lightheadedness
- Dizziness
- Fainting
- Extreme tiredness (fatigue)
In general, acute coronary syndrome is considered a medical emergency. Go to the nearest emergency room or call 911 in the U.S. if you or a loved one experiences sudden chest pain.
Causes
Commonly, people experience this syndrome due to the buildup of fatty deposits on the walls of blood vessels that supply the heart with oxygen-rich blood. These fatty deposits are also called plaque, and the coronary arteries are the heart’s blood vessels. Without treatment, fatty deposits may break and form a blood clot. As a result, arteries become narrowed or blocked, which limits blood flow to the heart and the rest of the body.
Furthermore, when the heart muscle does not get enough oxygen, its cells begin to die, causing damage to the heart tissue (also called a heart attack). Sometimes, cells in the heart may not die despite reduced oxygen levels. Anyway, the heart muscle does not work properly. When acute coronary syndrome does not cause cell death, the condition is called unstable angina.
Risk Factors
Healthcare providers have identified some factors that could elevate your risk of developing acute coronary syndrome. Check below some examples:
- Age – Older people are more prone to develop this condition than younger ones.
- Smoking
- Hypertension (high blood pressure)
- High cholesterol
- Unhealthy diets
- Lack of physical activity
- Excessive body weight or obesity
- Diabetes
- Family history of angina, myocardial infarctions, or strokes
- Medical history of hypertension, preeclampsia, diabetes, or other chronic health conditions during pregnancy
- COVID-19 infection
Diagnosis
This condition requires immediate treatment, which is often given to patients in the hospital. Once the treatment begins, doctors will perform some tests to determine the exact cause of the disease. They may ask some questions about your medical and family history. Check below some tests used to confirm acute coronary syndrome:
- Electrocardiogram (ECG or EKG) – This is a painless and quick test used to measure the electrical activity of the heart. It involves several sensors (electrodes) that are attached to the chest, arms, and legs (sometimes) and then to a computer that shows the results. An EKG can identify the exact location of the blockages and other changes in the heartbeat.
- Blood tests – These tests can show certain proteins that leak from the heart into the blood due to heart damage.
Other Tests
However, doctors may perform additional tests to confirm the condition and rule out others that cause similar symptoms. For example:
- Coronary angiogram – This test uses a catheter (a long and flexible tube) that is inserted into an artery (usually in the groin or wrist) and then guided to the heart. It helps identify blockages in the coronary arteries.
- Echocardiogram – This is an imaging test that uses sound waves to make pictures of the beating heart. It helps see how blood flows through the heart and its valves.
- Myocardial perfusion imaging – It also shows how the blood flows through the heart muscle, but it also involves a small amount of radioactive substance, often given intravenously (IV).
- CT (computerized tomography) angiogram – This test is used to get cross-sectional images of different structures and organs of the body. In such cases, it helps to look at the coronary arteries.
- Stress test – This procedure involves testing the heart muscle during physical activity. It usually involves walking on a treadmill or riding a stationary bike. A stress test helps determine how well your heart works.
Treatment
The goal of immediate treatments for people with acute coronary syndrome is to reduce pain, improve blood flow, and restore heart function. Treatments that usually involve medicines and surgery may also help reduce the risk of serious complications (such as myocardial infarctions).
Medicines
Check below some medicines often prescribed by doctors for people with this syndrome:
- Clot busters – These are specific medications used to break up a blood clot that blocks an artery. Another name for this medication is thrombolytics.
- Nitroglycerin – This medicine temporarily widens arteries, which helps improve blood flow.
- Antiplatelet medications – This group of medications is also prescribed to prevent the formation of blood clots. Doctors often recommend Aspirin, Clopidogrel, and Prasugrel.
- Beta-blockers – These drugs are used to relax the heart muscle and slow the heart rhythm. Commonly, doctors prescribe Nadolol and Metoprolol.
- Angiotensin-converting enzyme (ACE) inhibitors – The following medicines are prescribed by doctors to widen blood vessels, which helps improve blood flow. As a result, the heart works better. They often recommend Benazepril, Lisinopril, and others.
- Angiotensin receptor blockers (ARBs) – These medicines are antihypertensives, meaning they help control blood pressure. Healthcare professionals often prescribe Losartan, Irbesartan, and others.
- Statins – This group of medications is used to reduce the cholesterol levels in the blood. They also help stabilize fatty deposits and reduce the risk of blood clot formation. Doctors often prescribe Simvastatin, Atorvastatin, and others.
Surgery and Other Treatments
The following procedures are often recommended by doctors when medicines do not help restore blood flow. For example:
- Angioplasty and stenting – During this treatment, doctors use a thin and flexible tube with a small balloon that helps open clogged arteries of the heart. This tube is often inserted into a major artery, usually in the groin, and then guided to the narrowed or blocked artery. Thereafter, the balloon is inflated in the artery. When blood flow is restored, doctors use a stent to keep the artery open.
- Coronary artery bypass surgery – This is a major surgery that involves grafts (pieces of healthy blood vessels from another part of the body, such as the chest or leg) to make a new way for blood to flow to the heart.
Lifestyle Changes
The following changes may help keep the heart muscle healthy as well as reduce the risk of a heart attack. Check below some examples:
- Quit smoking – If you have problems with smoking cessation, discuss it with your healthcare professional.
- Adopt a heart-healthy diet – This includes fruits, vegetables, and whole grains. At the same time, you should limit or avoid low-fat dairy and lean products.
- Regularly perform physical exercise – It is advised to aim for at least 30 minutes of physical exercise per day.
- Regularly check your blood pressure and cholesterol levels
- Try to get and maintain a healthy weight. Excessive body weight may lead to multiple health problems, including diabetes, high cholesterol, hypertension, heart disease, and other diseases.
- Manage stress
- Limit or avoid alcoholic beverages
- Practice good sleep habits – The risk of developing heart disease or other chronic health conditions significantly increases with poor sleep. It is advised to get at least 7 hours of sleep per day.
Frequently Asked Questions
Is acute coronary syndrome life-threatening?
Yes, this condition is considered a medical emergency because it can be life-threatening. In people with this syndrome, the blood flow to the heart is decreased or blocked. As a result, it may lead to a serious complication called myocardial infarction.
What are the symptoms of coronary artery disease?
These include:
- Pain, numbness, coldness, or weakness that often occurs in the legs or arms
- Breathing problems (such as shortness of breath)
- Abdominal (belly) or back pain
- Chest pain (angina)
If any of the previous symptoms occur, immediately contact your healthcare professional.
What is the acute coronary syndrome?
A medical term that describes certain conditions that limit or block blood flow to the heart is acute coronary syndrome. If you have additional questions, ask your healthcare provider.
