Emergency Medicine: Open Access
Open Access

Acute Coronary Syndrome: Signs, Symptoms, Diagnosis, Prevention and Treatment

Hemant Sahani^{* *}Correspondence: Hemant Sahani, Department of Health System and Health Policy, Indian Institute of Public Health-Gandhinagar, Gandhinagar, India, Email:

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Description

Acute Coronary Syndrome (ACS) is a syndrome (a group of symptoms) brought on by a reduction in blood supply to the heart's muscles, which causes some of the heart muscle to either stop working altogether or to die. The most typical symptom is centrally situated; crushing chest discomfort that frequently radiates to the left shoulder or angle of the jaw and is accompanied by nausea and perspiration. Particularly in women, older individuals, and those with diabetes mellitus, acute coronary syndromes frequently present with symptoms other than chest pain.

Depending on the duration of symptoms, the existence of An Electrocardiogram (ECG) alterations, and the findings of blood tests, acute coronary syndrome is categorized into three scenarios: ST elevation myocardial infarction, non-ST elevation myocardial infarction, or unstable angina. Unstable angina typically occurs when symptoms last fewer than 30 minutes. Acute myocardial infarction is the diagnosis if symptoms last for more than 30 minutes.

The difference between ACS and stable angina, which appears during stress or physical activity and goes away after rest, should be made. In contrast to stable angina, unstable angina strikes unexpectedly, frequently when at rest, with little effort, or with less effort than the person's previous angina. Since new-onset angina implies a problem with a coronary artery, it is also regarded as unstable angina.

Acute Coronary Syndrome frequently shows a degree of atherosclerotic damage to the coronaries. Good living, exercise, treatment for diabetes and hypertension, quitting smoking, and maintaining healthy cholesterol levels are the main ways to prevent atherosclerosis. Aspirin has been demonstrated to lower the incidence of cardiovascular events in people with major risk factors. In relation to myocardial infarction, secondary prevention is considered. Acute coronary syndrome hospital admissions decreased by 17% in Scotland after a smoking banwas implemented in all enclosed public areas in March 2006.

Non-smokers accounted for 67% of the decline. Aspirin, clopidogrel or ticagrelor, nitroglycerin, and morphine are frequently used to treat patients with suspected ACS. The benefits of other analgesics, like nitrous oxide, are uncertain. If an individual has either a new ST elevation or a new left or right bundle branch block on their ECG, angiography is advised. It doesn't seem that extra oxygen is helpful unless the person has low oxygen levels. Males experiencing chest pain and a normal or non-diagnostic ECG are more likely than females to have acute coronary syndrome. The sensitivity and specificity of this study were 65.2% and 44%, respectively. The prevalence of acute coronary syndrome in this study was 8.4%; therefore, the positive predictive value of having coronary syndrome in a male with chest pain is 9.6%, and the negative predictive value is 93.2. Exercise electrocardiography was discovered to be a similarly poor predictor of acute coronary syndrome during follow-up in a second cohort trial. 47% of the participants who experienced a coronary event six years after the study's start had a negative ECG. The receiver operating characteristic curves gave the resting ECG a score of 0.72 and the workout ECG a score of 0.74 with an average follow-up of 2.21 years. For ACS diagnosis, prognosis scores are available in addition to prediction scores.

The grace ACS Risk and Mortality score is particularly notable because it aids in diagnosis and forecasts a patient's mortality rate based on that score. Its grading method considers both clinical data (blood pressure, heart rate, and EKG abnormalities) and medical background. Chest pain, which is felt as tightness around or over the chest and radiates to the left arm and left angle of the jaw, is the primary sign of severely reduced blood supply to the heart. Shortness of breath, diaphoresis (sweating), nausea, and vomiting may also be present. The sensation is frequently "atypical," with diverse types of pain being felt or even no pain at all (which are more likely in female patients and those with diabetes). Some people may experience palpitations, anxiety, angor animi, or a sensation of approaching doom. Since ACS is not specifically mentioned, the description of the chest discomfort as a pressure is not very helpful in making a diagnosis.