ACUTE CORONARY SYNDROME

27 May 2019

ABSTRACT –

Acute Coronary Syndrome involves sudden reduction in blood flow to the heart. Patient may feel pain, pressure or discomfort in the chest like heart attack. It can also be felt while resting or doing some light activity as well. It does not cause cell death but reduced blood flow affects working of the heart which might arise the risk of heart attack. Acute Coronary Syndrome should be diagnosed and treated promptly to improve health and prevent future problems. Treatments are different according to patient’s health conditions and symptoms.

CAUSES –

  • Buildup of plaques which is fatty deposits in the walls of coronary arteries.
  • Plaques leading to clot formation which blocks oxygen and nutrients flow to the heart muscles.

SIGNS AND SYMPTOMS –

  • Restlessness and fatigue
  • Pain, pressure, discomfort or burning feeling in the chest
  • Pain radiates from chest to back, neck, shoulders or arms (Especially towards left hand)
  • Nausea
  • Heavy sweating
  • Shortness of breath

DIAGNOSIS –

  • ECG (Electrocardiogram)
  • Blood Tests
  • Coronary Angiogram – A liquid dye is injected in the coronary arteries to check how it flows to the heart. X-ray shows blockages and narrowed arteries if there are any.
  • Echocardiogram – It directs sound waves towards heart to produce live video images of the heart. It shows which part of heart is affected and whether it is pumping properly or not.
  • Myocardial Perfusion Imaging/ Nuclear Scan – Safe amount of radioactive material is injected into the blood, specialized cameras take images of blood path with the radioactive substance flowing through it to show blood flow to the heart is enough or not.
  • CT Angiogram – It is specialized X-ray technology to detect narrowed arteries or blockages.
  • Stress Test – It shows how the heart, its muscles and blood vessels work during exercise or exertion. During stress test ECG, Echocardiogram or other tools can also be used.

TREATMENT –

It can be treated with Medications which include:

  • Thrombolytics, Antiplatelet drugs – To dissolve clots
  • Nitroglycerin, ACE inhibitors – To improve blood flow
  • Beta blockers – To relax heart muscles, slowdowns heart rate and lowers BP
  • Angiotensin receptor blockers – To control BP
  • Statins – To reduce cholesterol and plaque deposits

Surgery and other Procedures –

  • Angioplasty and Stenting – Long and tiny tube is inserted into the narrowed artery or blocked area to open the artery and deflated balloon is passed through the tube which collects plaque deposits into it.
  • Coronary Bypass Surgery – It creates an alternative route for blood to flow.

PREVENTIONS –

  • No smoking
  • Heart-healthy diet is must
  • Regular exercise and physically active body can prevent this
  • Keep a check on and maintain cholesterol level
  • Control blood pressure
  • Weight maintenance according to BMI
  • Stress Management

RISK FACTORS –

  • Risk increases with increasing age
  • High BP
  • High blood cholesterol
  • Smoking
  • Lack of physical exercise
  • Overweight
  • Unhealthy diet
  • Type 2 diabetes
  • Family history

EPIDEMIOLOGY –

  • As per the estimation, 1.8 million people die annually because of Acute Coronary Syndrome.
  • Overall, 7.5 million deaths occur due to heart diseases including ACS.
  • More prevalent in men till an age below 60 but becomes prominent in women after the age of 75 and above.

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