JAMA PATIENT PAGE | Cardiology
Acute Coronary Syndrome
Acute coronary syndrome (ACS) refers to a group of conditions
characterized by poor blood flow to heart muscle.
Acute Coronary Syndrome (ACS)
ACS Symptoms
Pain
Chest pain (most
common)
Arms, shoulders,
neck, jaw, back,
or upper abdomen
Blocked blood vessel that
supplies the heart muscle
Heart
Coronary
artery
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ACS includes both unstable angina (increasing chest pain, or chest
pain at rest) and myocardial infarction (heart attack). Most cases
are caused by a blocked blood vessel in the heart. Because of the
blockage, the heart muscle does not get enough blood or oxygen.
A Rational Clinical Examination in the November 10, 2015, issue of
JAMA provides more information on ACS. Patients who already have
blocked blood vessels in the heart have especially high risk for ACS.
Other risk factors include
High blood pressure
High cholesterol
Cigarette smoking
Diabetes
Increasing age
What Are the Symptoms?
Pressure-like chest pain
Pain in the shoulders (one or both), jaw, or back
Shortness of breath
Cool, clammy skin
Nausea
Lightheadedness
Other conditions can cause these symptoms. But if you do have ACS,
you will need emergency treatment. The time between start of symptoms and treatment should be as short as possible. If you have chest
pain, especially if you have 1 or more of the above risk factors,
call 911 (in the United States).
At the hospital, doctors will examine you and take your medical history. They will also check your heart rhythm and do a blood
test. This test can show if your heart muscle has been injured.
Basedontheresults,youmightbesenthomeandaskedtoseeyour
usual doctor. Or you might be admitted to the hospital for treatment.
How Is ACS Treated?
Treatmentsincludemedicinestoloweryourbloodpressure,loweryour
cholesterol, and keep your blood from clotting. These medicines will
be started in the hospital, but you will still need to take them after you
go home. You may also need to have cardiac catheterization. In this
procedure, the doctor injects dye into blood vessels in the heart. This
helps show where the vessels are blocked. You might also receive a
coronary stent at this time. The stent helps keep blocked blood [Link],youmightneedtohaveopenheartsurgeryinstead.
Authors: Alexander C. Fanaroff, MD; Jennifer A. Rymer, MD, MBA;
Sarah A. Goldstein, MD
Conflict of Interest Disclosures: All authors have completed and submitted the
ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Sources: American Heart Association, American College of Cardiology.
1990
Other symptoms
Shortness of breath; cool, clammy
skin; nausea; and lightheadedness
Decreased blood flow
to the heart muscle
How Can I Reduce My Risk?
Eat a healthful diet
Exercise regularly
Quit smoking (or dont start)
Control your blood pressure and cholesterol
Control your blood sugar if you have diabetes
Ask your doctor about taking a low-dose aspirin every day
FOR MORE INFORMATION
National Heart, Lung, and Blood Institute
[Link]/
American Heart Association
[Link]/HEARTORG/
American College of Cardiology
[Link]
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JAMA November 10, 2015 Volume 314, Number 18 (Reprinted)
Copyright 2015 American Medical Association. All rights reserved.
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