Acute Coronary Syndrome
Overview
Acute Coronary Syndrome or ACS is an umbrella term for all conditions that result in a sudden decrease in blood flow to the heart. The heart is a muscular pump and requires nutrients and oxygen to function, which is supplied by three coronary arteries. Deposition of fat narrows the coronary arteries. These deposits are called plaques. Whenever these plaques rupture, there is an accumulation of thrombus or blood clots. This leads to a complete cutoff of blood supply to the part of the muscles that are being supplied with blood by that artery. The most common ACS conditions are Unstable Angina and ST-segment Elevation Myocardial Infarction (STEMI). STEMI is also known as a heart attack in layman’s terms.
Risk factors
ACS is caused due to many factors including:
- High blood pressure
- Increased cholesterol
- Increased blood sugar or diabetes
- Obesity especially abdominal obesity
- Sedentary lifestyle
- Lack of exercise
- Unhealthy food habits especially consumption of high saturated fat in the diet
- Smoking history or a history of taking tobacco in any form
Signs and Symptoms Acute Coronary
Syndrome often manifests itself with a severe chest pain (which lasts for more than 10 minutes) or a pain travelling from chest to shoulders and arms. However, this may not always be the case, and patients may have atypical and varied symptoms
In cases of ACS, any prestigious centre doing primary angioplasty for heart attacks should have a 24x7 facility and door to balloon time should be 60 minutes. Accordingly, Max Institute of Heart and Vascular Science (MIHVS) has this facility available. Even for patients requiring high-end support for maintaining blood pressure, all amenities are available. What’s more, we have a heart care team available 24x7 to prevent delay in any treatment; support and management of patients is the hallmark of management Max Healthcare.
To understand the exact cause of ACS symptoms, doctors at Max Institute of Heart and Vascular Science (MIHVS) begins with a thorough examination of the patient’s medical history. If the doctor suspects an ACS condition, then he/she might ask the patient to undergo the following diagnostic tests:
- Blood test: To check whether there is any evidence of damage or injury to the heart cells.
- Electrocardiogram (ECG or EKG): To detect any abnormality in the functioning of the heart, by measuring its electrical activity.
Once the tests confirm an Acute Coronary Syndrome (ACS) condition, doctors will then take further steps to treat the blockage. The Department of Cardiac Surgery works closely with the Cardiology Department as a team and creates a personalized treatment plan tailored to fit the patient’s overall health.
Although treatments can help in controlling and managing the conditions, the risk is always there. Regular checkups and sticking to the treatment plan can surely help you in:
- Preventing the blood from clotting
- Regulating the blood pressure
- Keeping your cholesterol levels and sugar levels under control
- Regulating the blood flow to and from heart
At Max Institute of Heart and Vascular Science (MIHVS), we have the latest technology that lets us treat ACS in the best way possible; blood pressure support, Intra-aortic balloon pump, cutting and scoring balloons, intravascular lithotripsy, thrombus aspiration catheters are some of the facilities are also available. The treatment goal in ACS conditions is to remove the blockage in the arteries and regulate the blood flow. It can be done with the help of a medicinal regime, angioplasty and stenting or surgery, depending on the condition and the amount of blockage. In most cases, treatment may include:
- Coronary Angiography: In patients with ST-segment Elevation Myocardial Infarction, the artery is opened as soon as possible. The best way is to subject the patient to coronary angiography and open the artery with a balloon and stent. If the patient can not be taken to a hospital with a stenting facility within 90 minutes of the first contact with medical personnel, it is recommended to give clot bursting medicines to the patient and later take the patient to a tertiary care hospital where all latest generation stents are available.
- Medications: The doctor can ask the patient to take a number of medicines including aspirin, other antiplatelets, beta-blockers, statins, blood thinners, etc. These help in breaking the blood clot, treating high blood pressure, relieving chest pain, and ultimately reducing the risk of a heart attack.
- Angioplasty: This procedure involves inserting a long, thin tube called a catheter inside the arteries to open the blockage. The catheter carries a small deflated balloon which is inflated once inside the arteries to open the blockage. The doctor may use a wire tube called a stent, to keep the artery open. The patient is kept under controlled anaesthesia during the process.
- Bypass surgery: This treatment option may be required for multivessel disease, left main artery disease or very calcified disease. This surgery is performed to re-route the blood around the blocked artery.