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Acute Coronary Syndrome

The acute coronary syndrome (ACS) is the development of chest pain of cardiac nature, often but not exclusively associated with an abnormal electrocardiogram (ECG). It is the most common presentation of myocardial infarction (heart attack), and investigations are aimed at confirming this pathology Most patients who have ST-segment elevation will ultimately develop a Q-wave acute myocardial infarction (heart attack). These life-threatening disorders are a major cause of emergency medical care and hospitalization in the United States.

Chest pain is one of the most frequent reasons for emergency department visits. Algorithms have been developed to aid in determining the likelihood that a patient has an acute coronary syndrome, and for those patients that do have an acute coronary syndrome, the risk of death or death and ischemic events.

Many hospitals have developed chest pain observation units to provide a systematic approach toward serial risk stratification to improve the triage process. In many cases those who have not experienced new chest pain and have no electrocardiographic changes or cardiac enzyme elevations undergo treadmill exercise tests or imaging procedures to exclude ischemia at the end of an 8- to 24-hour period and are discharged directly from the emergency department if these tests are negative. Differentiating acute coronary syndrome from noncardiac chest pain is the primary diagnostic challenge Patients with  often present in a similar manner. The distinction between non-STEMI and unstable angina is based on the presence or absence of a rise in cardiac enzymes or troponin. Unstable angina and non-ST-segment elevation myocardial infarction are very common manifestations of this disease.

Cause of A cute coronary syndrome

Some Cause of Acute coronary syndrome

  • These life-threatening disorders are a major cause of emergency medical care and hospitalization in the United States.
  • Other causes of reduced myocardial blood flow include mechanical obstruction (e.g. air embolus), dynamic obstruction (e.g. vessel spasm), and inflammation or infection.
  • Coronary heart disease is the leading cause of death in the United States
  • Other causes include arterial inflammation and secondary unstable angina. Arterial inflammation may be caused by or related to infection.
  • Spontaneous and cocaine-related coronary artery dissection remains an unusual cause of ACS and should be included in the differential diagnosis, especially when a younger female or cocaine user is being evaluated.
  • An aberrant left main coronary artery with its origin at the right sinus of Valsalva may cause ACS, especially with exertion.

Symptons of A cute coronary syndrome

Some sign and Symptons related Acute coronary syndrome:

  • Acute coronary syndrome is a clinical diagnosis, i.e. based on the medical history and physical examination it is the doctor's impression that the pain may originate from the heart.
  • The main symptoms of Long QT syndrome are dizziness or fainting attacks or loss of consciousness. This abnormal rhythm may occur during intense emotional excitement, during physical exertion, after taking certain medicines, or less commonly when the sufferer is at rest.
  • If the pain is severe, close monitoring and symptomatic treatment may already be given before all investigations are complete.
  • The patient may note a change in symptoms of cardiac ischemia with a change in severity or of duration of symptoms.

Treatment of Acute Coronary Syndrome

Treatment of acute coronary syndromes without ST elevation should be multifaceted and vigorous. Patients who are at high risk should be hospitalized, maintained at bed rest or at very limited activity, monitored, and given supplemental oxygen. Sedation with a benzodiazepine agent may help if anxiety is present. Most Treatment related to Acute coronary syndrome:

  • A common treatment is a betablocker, which is effective for the majority of patients.
  • Once the diagnosis has been made, patients with and without symptoms should be observed and treated to reduce the risk of sudden death.
  • A common treatment is a betablocker, which is effective for the majority of patients.
  • 160-325 mg of non-enteric coated aspirin to chew and swallow as soon as the diagnostic impression of ACS formed (patients presenting within 24 h). Thereafter daily oral dose indefinitely
  • A common treatment is a betablocker, which is effective for the majority of patients.

ACS can lead to heart attack. Administration of CPR during a heart attack can reduce the chance of serious brain damage or death. We recommend that all medical professionals get their CPR certification.


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