Acute Coronary Syndrome

Overview

Acute Coronary Syndrome or ACS is a catch all interval used to chronicle a set of symptoms consistent with acute myocardial ischemia when the symptoms are not pathognomonic. Myocardial ischemia is a condition in which insufficient blood flow is reaching the heart muscle. This is usually a crop of atherosclerotic plaques building up in the coronary arteries.

Symptom

The symptoms of ACS are typically tightness in the chest that radiates into the left arm, anxiety or a concept of impending doom, and shortness of breath. Other symptoms that might occur are nausea, vomiting, sweating and palpitations. In female patients, the elderly, and those with diabetes there is a higher occurence of atypical presentation. This can translate to other, non-specific, symptoms such as awareness weak or lightheaded to a complete absence of symptoms.

There are three distinct subtypes of ACS:

â Unstable Angina
â non-ST segment elevation myocardial infarction
â ST segment elevation myocardial infarction

Diagnosis

Diagnosis of ACS normally involves an Electrocardiogram. Elevation in the ST segment indicates that damage has occurred to the muscle and that intervention is required immediately. In the absence of ST segment elevation, it is also difficult to distinguish between unstable angina and non-ST segment elevation myocardial infarction. Blood tests can be administered to look for increases in cardiac enzymes. The most accurate indicators for myocardial infarction are increased Troponin I and Troponin T. A second, familiar predictor is an increased Creatine Kinase level. Another diagnostic thing that can be employed is the ACI-TIPI. The ACI-TIPI is a rough algorithm that uses demographic facts and EKG information to provide an estimate of the likelihood of myocardial infarction.

Treatment

In the chance of ST segment elevation myocardial infarction, there are various treatment options. Aspirin is often administered on-site by paramedics to contract clot size. Beta blockers are often administered to abbreviate the office load on the heart. Anticoagulants, such as heparin, may be administered to prevent further clots. ACE inhibitors are often administered to prevent some of the emotions enlargement. Clearing the blockage as soon as possible is key to patient survival in the case of ST segment elevation myocardial infarction. In most cases an angioplasty and stent placement is performed within an age or two when possible. Doctors can besides handle intravenous Thrombolytics to gap up clots.

For non-ST segment elevation myocardial infarction, the treatments tend to be the same, though without the same date constraints.

Provided an angioplasty is not a possible possibility due to latest surgery, a bleeding disorder, or multiple blocked arteries, coronary artery bypass surgery can be used to restore blood flow.
Michael Morales is an EMT paramedic and employer of education for Vital Ethics Inc., providing basic and advanced life aid knowledge and certification programs.

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Keywords:

myocardial, myocardial infarction, elevation myocardial, myocardial ischemia, pathognomonic myocardial, acute myocardial, likelihood myocardial, indicators myocardial