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Acute Coronary Syndromes

Acute coronary syndromes (ACS) is a term used to describe a group of conditions resulting from acute myocardial ischemia (insufficient blood flow to heart muscle) and ranging from unstable angina (increasing, unpredictable chest pain) to myocardial infarction (heart attack). The conditions are related to varying degrees of narrowing or blockage of single or multiple coronary arteries that provide blood, oxygen, and nutrients to the heart. This life-threatening disorder is a major cause of emergency medical care and hospitalization. Coronary artery disease (CAD) remains the leading cause of death in the United States. The July 2, 2008, issue of JAMA includes an article about treatment of acute coronary syndromes in men and women.

SYMPTOMS

Chest pain—uncomfortable pressure, squeezing, or fullness
Upper body discomfort—pain or discomfort in both arms, the back, neck, jaw, or abdomen
Shortness of breath
Other symptoms include sweating, nausea, and light-headedness

If you or someone you are with has chest pain, especially with one or more of these other symptoms or signs, call 911 in the United States or the number for medical emergencies in other locations. Acute coronary syndrome patients can benefit from immediate medical care. If cardiac arrest occurs (loss of responsiveness, no sign of breathing, no heartbeat or pulse), call 911 immediately and start CPR (cardiopulmonary resuscitation). Apply an automated external defibrillator, if available.

DIAGNOSIS AND POSSIBLE TREATMENTS

Initial assessment includes a complete medical history, physical examination, an electrocardiogram (ECG) test to evaluate the electrical activity of the heart, and blood tests to evaluate the presence of chemicals resulting from cardiac cell injury. Hospitalization may be necessary. Standard treatments for coronary artery blockage may include placement of stents (mesh tubes) within narrowed blood vessels or heart surgery for bypass grafting of blocked vessels.

WAYS TO REDUCE YOUR RISK OF CORONARY ARTERY DISEASE

Don't smoke

Control your blood pressure

Exercise on a regular basis

Eat a healthful diet

Maintain a reasonable body weight

Ask your doctor about taking a low dose of aspirin each day

FOR MORE INFORMATION

American Heart Association
http://www.americanheart.org

American College of Cardiology
http://www.acc.org

Source: JAMA. 2008;300(1):132.

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