Acute Coronary Syndrome (ACS)

What is Acute Coronary Syndrome? Acute coronary syndrome is an umbrella term for coronary artery diseases in which the patient is suspected or confirmed to have a myocardial infarction. These diseases involve the rupture of an atherosclerotic plaque that forms a thrombus or clot within the coronary arteries, blocking the blood supply to the heart. All forms of acute coronary syndrome result in symptoms.

Symptoms of Acute Coronary Syndrome 

Common symptoms of ACS include:

  • Substernal chest pain that presents as increased pressure or soreness radiating to the jaw or left arm.
  • Sweating
  • Trouble breathing
  • Nausea
  • Abdominal discomfort

What are the types of Acute Coronary Syndromes?

  • Myocardial infarction type I is further classified as:

ST-elevation myocardial infarction (STEMI): The patient presenting with symptoms has a positive increase of cardiac biomarkers and an elevation of the ST segment on the ECG.

Non-ST-elevation myocardial infarction (NSTEMI): The patient presenting with symptoms has a positive increase of cardiac biomarkers but no elevation of the ST segment on the ECG.

  • Unstable Angina (UA) refers to patients presenting with symptoms who have no elevation of the ST segment on the ECG and show little to no changes in the levels of the cardiac biomarkers. The development of high-sensitivity troponin assays has reclassified many patients initially diagnosed with UA as being NSTEMI.

Source: Bergmark, B. A., Mathenge, N., Merlini, P. A., Lawrence-Wright, M. B., & Giugliano, R. P. (2022). Acute coronary syndromes. The Lancet, 399(10332), 1347–1358. https://doi.org/10.1016/s0140-6736(21)02391-6