Acute Coronary Syndrome (ACS) is a significant problem in Australia and continues to be a significant cause of mortality and morbidity. It is estimated that there are 70,000 confirmed ACS cases in Australia each year which costs the healthcare system more than $1.8 billion annually. (Source: Heart Foundation)
Acute Coronary Syndrome is an umbrella term for a number of conditions related to poor blood supply to the heart. ACS is typically classified as an unstable angina, ST elevation myocardial infarction (STEMI) or a non ST elevation myocardial infarction (NSTEMI). These conditions are predominantly caused by a lack of oxygen supply to cardiac myocytes (heart muscle cells). Cells in the heart, like cells in the rest of the body, require oxygen to function. Occlusion of the coronary arteries leads to decreased blood supply, which then leads to decreased oxygen supply, and subsequently hypoxia. When the cells become hypoxic, they stop functioning properly.
Risk Factors:
- Smoking
- Hypertension (high blood pressure)
- Poor diet
- Lack of exercise
- Advanced age
- Family history
Symptoms:
- Chest pain (crushing, tightness or fullness)
- Radiating pain into jaw, shoulder, neck, back and/or arms
- Diaphoresis (sweating for no obvious reason)
- Nausea
- Shortness of breath
*Diabetics may present with minimal symptoms. Call 000 if in doubt.
First Aid:
- Sit the patient in a comfortable position and call 000.
- Assist patient with medications such as Glyceryl Trinitrate (GTN), as directed by their health care professional.
- Give the patient a 300mg Aspirin tablet to chew, unless they are known to be allergic to the drug.
Professional Assessment & Treatment:
The initial assessment for Acute Coronary Syndrome is an Electrocardiogram (ECG). This will measure the electrical activity of the heart and assess the timing of the electrical wave. The healthcare professional will be looking for signs of a STEMI.
A blood test will also be conducted, specifically looking at troponin levels (a protein which is released into the blood after heart cell death).
Other tests can include a Chest X-ray (to rule out respiratory conditions) and possibly an angiogram to view and potentially treat the occluded vessels.
Depending upon the outcome of the assessment, patients may require a pharmacological treatment plan. The aim of these medications is to decrease the oxygen demand of heart cells, decrease cholesterol levels in the blood, prevent the blood from clotting and prevent platelet adhesion.
Conclusion:
Optimal patient outcomes depend on rapid action, not only by healthcare professionals but also the general public. Share this article among your friends and family and together lets learn the symptoms, risk factors and treatment of Acute Coronary Syndrome.