Heart attack - ACS; Myocardial infarction - ACS; MI - ACS; Acute MI - ACS; ST elevation myocardial infarction - ACS; Non ST-elevation myocardial infarction - ACS; Unstable angina - ACS; Accelerating angina - ACS; Angina - unstable-ACS; Progressive angina Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the heart muscle. When blood cannot flow to the heart muscle, the heart muscle can become damaged. Heart attack and unstable angina are both acute coronary syndromes (ACS). A fatty substance called plaque can build up in the arteries that bring oxygen-rich blood to your heart. Plaque is made up of cholesterol, fat, cells, and other substances. Plaque can block blood flow in two ways: Many risk factors for heart disease may lead to an ACS.
You feel a tight band of pain around your chest. The pain moves from your chest to your arms, shoulder, and neck. What could your pain mean? Could it be a heart attack, could it be the big one? Heart attacks are caused by interruption of blood supply to part of the heart. If the blood flow is blocked, your heart is starved of oxygen and heart cells die. A hard substance called plaque can build up in the walls of your coronary arteries. This plaque is made up of cholesterol and other cells. A heart attack can occur as a result of plaque buildup or the rupture of one of these plaques. We're not sure why heart attacks occur when they do. You may have a heart attack when you are resting or asleep, or after a sudden increase in physical activity, when you are outside in cold weather, or after a sudden, severe emotional or physical stress, including an illness. So, how is a heart attack treated? If you go to the hospital for a suspected heart attack, a doctor or nurse will listen to your chest with a stethoscope. You will have a blood test to look for heart damage. A coronary angiography test can show your doctor how well blood is moving through your heart. If blood moves slowly, or not at all through your coronary arteries, you have either a narrowed, or blocked artery. Other tests can look at the valves and chambers of your heart and check for abnormal heart rhythms. If you've had a heart attack, doctors can do an emergency procedure called angioplasty. This surgery or procedure can open narrowed or blocked blood vessels. Usually they'll place a small, metal mesh tube, called a stent, in your artery to help keep it open. You may also receive drugs to break up the clot in your artery. Sometimes, doctors will do heart bypass surgery to get blood flowing to your heart muscle again. After you are treated in the hospital for a heart attack, you may need to take medicines to thin your blood, to protect your heart, or to improve your cholesterol levels. You may need to take these medicines for the rest of your life. Most people who have had a heart attack also need cardiac rehabilitation. This will help you slowly increase your exercise level and learn how to follow a healthy lifestyle. After you have a heart attack, your chance of another is higher. How well you do after a heart attack depends on the damage to your heart and where the damage is, and what steps you take to prevent another one. If your heart can no longer pump blood to your body as well as it used to, you may have heart failure and will need lifelong treatment. Usually a person who has had a heart attack can slowly go back to normal activities, but you will need to take steps to prevent another heart attack.
The most common symptom of ACS is chest pain. The chest pain may come on quickly, come and go, or get worse with exercise or rest. Other symptoms can include:
Women and older people often experience these other symptoms, although chest pain is common for them as well.
Your health care provider will do an exam, listen to your chest with a stethoscope, and ask about your medical history. Tests for ACS include:
Coronary angiography may be done right away or when you are more stable. This test:
Other tests to look at your heart that may be done while you are in the hospital include:
Your provider may use medicines, surgery, or other procedures to treat your symptoms and restore blood flow to your heart. Your treatment depends on your condition and the amount of blockage in your arteries. Your treatment may include:
How well you do after an ACS depends on:
In general, the quicker your artery gets unblocked, the less damage you will have to your heart. People tend to do best when the blocked artery is opened within a few hours from the time symptoms start.
In some cases, ACS can lead to other health problems including:
An ACS is a medical emergency. If you have symptoms, call 911 or the local emergency number quickly. Do not:
There is a lot you can do to help prevent ACS.
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Last reviewed on: 5/8/2022 Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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