- Chest pain or discomfort, which may involve pressure, tightness or fullness.
- Pain or discomfort in one or both arms, the jaw, neck, back or stomach.
- Shortness of breath.
- Feeling dizzy or lightheaded.
- Nausea.
- Sweating.
Which is the most common cause of ACS?
Acute coronary syndrome (ACS) is caused primarily by
atherosclerosis
. Most cases of ACS occur from disruption of a previously nonsevere lesion (an atherosclerotic lesion that was previously hemodynamically insignificant yet vulnerable to rupture).
What are some atypical presentations of ACS?
Despite its dreaded nature, 33% of ACS may mislead clinicians with atypical presentations [1], which could be dyspnea (49.3%), diaphoresis (26.2%),
nausea/vomiting
(24.3%), or presyncope/syncope (19.1%), in the order of dominant presenting symptoms [2].
What are the three types of ACS?
Non-ST-elevation myocardial infarction (NSTEMI), ST-elevation MI (STEMI), and unstable angina
are the three traditional types of ACS.
What are the components of acute coronary syndrome?
The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia and includes
unstable angina (UA), non—ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI)
.
What is the immediate treatment for ACS?
Morphine (or fentanyl)
for pain control, oxygen, sublingual or intravenous (IV) nitroglycerin, soluble aspirin 162-325 mg, and clopidogrel with a 300- to 600-mg loading dose are given as initial treatment.
How is ACS defined?
Acute coronary syndrome is a term used to describe
a range of conditions associated with sudden, reduced blood flow to the heart
. One such condition is a heart attack (myocardial infarction) — when cell death results in damaged or destroyed heart tissue.
How is ACS diagnosed?
A blood test can show evidence that heart cells are dying.
An electrocardiogram (ECG or EKG)
can diagnose an acute coronary syndrome by measuring the heart’s electrical activity.
What is the difference between CAD and ACS?
Introduction and definitions
On the other hand, CAD is characterized by atherosclerosis in coronary arteries and can be asymptomatic, whereas ACS almost always presents with a symptom, such as
unstable angina
, and is frequently associated with myocardial infarction (MI) regardless of the presence of CAD (2).
How do you prevent ACS?
Heart disease can lead directly to acute coronary syndrome, but those who do not have heart disease can protect themselves by practicing a
healthy lifestyle
: Following a heart-healthy diet: Eating a diet that includes fruits, vegetables, whole grains, and lean protein.
What are the symptoms of high risk Atypical presentations?
- Acute abdomen with constipation and decreased appetite, rather than severe pain.
- Pneumonia with vague chest pain and dry cough, rather than fever.
- Depression with agitation, rather than dysphoria.
- Infection with falls, rather than fever or elevated white count.
What is the most common atypical symptom of ACS in elderly patients?
Atypical symptoms
Notably, chest pain as a presenting symptom occurs in only 40% of patients older than 85 years but is present in nearly 80% of patients under 65 years. Common symptoms in the elderly presenting with ACS include
dyspnea, diaphoresis, nausea and vomiting, and syncope
.
What increases the likelihood of atypical chest pain presentation?
The risk factor profile of MI patients without chest pain is presented in Table 2. Six important variables associated with atypical presentation (in descending hierarchy) were prior heart failure, prior stroke, older age,
diabetes
, female sex, and nonwhite racial/ethnic group.
Can ACS lead to MI?
Two types of MI that can be produced by ACS.
ST-Elevation myocardial infarction
(STEMI), so named because the “ST segment” on the ECG appears “elevated,” occurs when a coronary artery is completely blocked so that a large proportion of the heart muscle being supplied by that artery begins to die.
Is IHD and CAD the same?
Sometimes you’ll hear coronary artery disease called other names, like ischaemic heart disease (IHD), or coronary heart disease (CHD). Sometimes it’s just called heart disease. These are just different terms
for the same condition
.
Does ACS include stable angina?
ACS should be distinguished from stable angina, which
develops during physical activity or stress and resolves at rest
. In contrast with stable angina, unstable angina occurs suddenly, often at rest or with minimal exertion, or at lesser degrees of exertion than the individual’s previous angina (“crescendo angina”).
