Acute Coronary Syndrome

Let's imagine: you are doing your own thing, and suddenly you feel a tightness in your chest, as if your heart is being tightened, followed by waves of severe pain... This means that you may be experiencing acute coronary syndrome! Don't be afraid, let's understand what this mysterious "little monster" is and how we can deal with it.

1. What is acute coronary syndrome

Acute Coronary Syndrome (ACS) is an acute cardiovascular event, usually caused by insufficient blood flow to the coronary arteries, and includes two main types: angina pectoris and myocardial infarction. When these conditions occur, the heart muscle does not receive enough oxygen, resulting in damage to the heart muscle or death. Angina pectoris is a transient chest pain or discomfort caused by insufficient blood flow to the coronary arteries, which usually occurs when the heart is overloaded, such as during exercise or emotional excitement. Myocardial infarction is myocardial ischemia or myocardial necrosis caused by coronary artery blockage, which may lead to severe heart dysfunction or even death. The occurrence of acute coronary syndrome is often associated with atherosclerosis, a chronic disease that gradually leads to coronary artery stenosis and plaque formation. ACS is a serious cardiac event that requires timely diagnosis and treatment to relieve symptoms, prevent complications, and improve patient survival.

What are the symptoms of acute coronary syndrome?

1. Chest pain or discomfort

This is one of the most common symptoms of acute coronary syndrome, especially angina pectoris. Patients may describe it as a pressure, fullness, or stabbing pain, often located behind the sternum, in front of the heart, or in the left arm radiating to the neck or jaw. This chest pain usually occurs during activity or emotional excitement and may last for several minutes or longer.

2. Difficulty breathing

Some people may experience shortness of breath or shortness of breath, especially if it accompanies an angina attack.

3. Nausea and vomiting

In the setting of an acute myocardial infarction, patients may experience nausea and vomiting, which may be associated with pain or anxiety.

4. Sweating

People may sweat profusely, especially during episodes of pain, which may be due to severe stress on the heart or lack of oxygen.

5. Dizziness or fainting

Some people may experience dizziness or fainting during an ACS, which may be caused by insufficient blood flow to the heart.

3. How to provide first aid after acute coronary syndrome

1. Call emergency number immediately

The first step is to call emergency services immediately, dial 911 or other local emergency numbers, and inform the dispatcher of the patient's symptoms and condition. It is critical to seek medical help as soon as possible so that professional medical personnel can arrive at the scene as soon as possible and send the patient to a nearby chest pain center as soon as possible.

2. Keep the patient quiet

Keep the person calm while waiting for emergency services to arrive. Lay them flat on the ground or in a comfortable position and keep them stable. If the person is conscious, keep them relaxed and avoid excessive movement.

3. Provide oxygen

If oxygen is available, give the person oxygen to increase blood oxygen levels and reduce the workload on the heart. Oxygen therapy can be given using a mask or nasal cannula, as directed by your healthcare provider or first responder.

4. Auxiliary medication

If the patient has symptoms of angina, consider giving nitroglycerin. Nitroglycerin can help dilate the coronary arteries and increase blood supply to the heart. If the patient has already taken nitroglycerin and has not seen significant improvement, they should stop taking it and wait for emergency medical services to arrive.

5. Monitor vital signs

While waiting for emergency personnel to arrive, regularly monitor the patient's vital signs, including heart rate, breathing, and level of consciousness. If the patient suddenly stops breathing or heartbeat, start CPR immediately.

What are the complications of acute coronary syndrome?

1. Myocardial infarction

Acute coronary syndrome is caused by acute obstruction of the coronary artery, which leads to myocardial ischemia. If the ischemia lasts too long or is too severe, it may lead to myocardial infarction. Myocardial infarction is a serious complication that can cause necrosis and loss of function of myocardial tissue, seriously affecting the patient's quality of life and prognosis.

2. Arrhythmia

Patients with acute coronary syndrome often have arrhythmias. This may include atrial fibrillation, ventricular tachycardia, ventricular fibrillation, etc. The occurrence of arrhythmias will further increase the heart load, lead to worsening heart function, and increase the risk of sudden death.

3. Heart failure

Patients with acute coronary syndrome may experience symptoms of heart failure due to impaired heart function caused by myocardial infarction or myocardial ischemia. Heart failure is manifested by decreased heart pumping function, causing symptoms such as dyspnea, edema, fatigue, etc., which seriously affects the patient's quality of life.

4. Cardiogenic shock

Cardiogenic shock is a serious cardiovascular emergency characterized by a sudden drop in effective circulating blood volume, resulting in insufficient perfusion of tissues and organs throughout the body. This may be due to extensive myocardial infarction and impaired cardiac pumping function.

5. Vascular complications

Patients with acute coronary syndrome may also develop other vascular complications, such as coronary artery rupture, coronary artery aneurysm formation, coronary artery fistula, etc. These complications may cause intravascular bleeding, vascular wall damage, thrombosis, etc., and further aggravate the patient's condition.

5. What precautions should patients with acute coronary syndrome take?

1. Take medication as directed by your doctor

Doctors will prescribe appropriate drugs according to the patient's specific conditions, such as antiplatelet drugs, nitrate drugs, etc. Patients should strictly follow the doctor's orders, take the medicine on time and in the prescribed dosage, and should not stop taking the medicine or change the medication regimen on their own.

2. Avoid strenuous activities

During the acute period, patients should avoid strenuous physical activity to avoid increasing the burden on the heart, aggravating symptoms or inducing cardiac events. Patients should try to maintain a happy and relaxed mood and avoid long-term tension and anxiety.

3. Regular review and monitoring

After treatment, patients need to have regular review and monitoring of heart function and related indicators, including electrocardiogram, myocardial enzyme spectrum, etc. This helps to evaluate the treatment effect, adjust the treatment plan in time, and monitor the patient's recovery.

4. Maintain a healthy lifestyle

Patients with acute coronary syndrome should actively adjust their lifestyle, including quitting smoking, controlling diet, maintaining moderate exercise, and controlling weight, to reduce the risk of cardiovascular events and promote recovery.

Conclusion

Dear friends, today we have experienced a medical adventure together and got to know the "little monster" that has attracted much attention - acute coronary syndrome. Perhaps this term is not unfamiliar in our lives, but understanding its principles and coping methods is basic common sense that everyone should have. When we encounter acute coronary syndrome, don't panic or take it lightly. Taking correct measures in time, especially seeking medical help, is the key to protecting yourself and others. At the same time, we should also pay attention to prevention, maintain good living habits, stay away from bad habits, have regular physical examinations, and care about our heart health.

Author: Lin Dong Jieyang People's Hospital Emergency Department