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What is acute coronary syndrome?

Acute coronary syndrome (ACS) is an umbrella term for a range of conditions where blood supply to the heart is blocked.

ACS encompasses signs and symptoms that typically indicate a person is having a cardiac event, such as a heart attack.

The 3 types of acute coronary syndrome

There are three main types of ACS.

  • STEMI (ST-elevation myocardial infarction): This is a heart attack caused by a sudden and prolonged blockage of blood supply to the heart. A large area of the heart is affected, so in an electrocardiogram (ECG), a segment is elevated compared to normal. The blood levels of key chemical markers in the body are also elevated.
  • Non-STEMI: This is a heart attack where the blockage of blood supply to the heart may be partial or temporary, so the damage to the heart is relatively small. It may not cause changes on an ECG, but key chemical markers in the blood will be elevated.
  • Unstable angina: Angina is a type of pain or discomfort in the chest that is a symptom of an underlying problem with the heart. Unstable angina is a change from stable angina – the angina may occur more frequently or easily, feel more severe, or last longer. It is treated as seriously as a confirmed heart attack.

What is the difference between heart attack and acute coronary syndrome?

ACS and heart attack are different. The term ACS covers a range of conditions linked to sudden, reduced blood flow to the heart, including heart attack and angina. Heart attack is a type of ACS.

The most common causes

The most common cause of ACS is development of a blood clot in a coronary artery that blocks the supply of blood to the heart. These clots can form as a result of atherosclerosis. In this slow, progressive process, atherosclerotic plaques composed of fat, cholesterol and other substances build up in the walls of the arteries. These plaques harden over time, narrowing the opening of the arteries and restricting blood flow. If these plaques break open, they form a blood clot. Atherosclerosis is the main underlying cause of cardiovascular disease.

ACS is a lead­ing cause of death and hos­pi­tal­i­sa­tions worldwide.

The main symptoms of acute coronary syndrome

The main symptoms of ACS include:

  • Pain, pressure or an aching sensation in the chest or arms that can spread to the neck, jaw or back
  • Shortness of breath
  • Nausea, indigestion, heartburn or abdominal pain
  • Lightheadedness or sudden dizziness
  • Fatigue
  • Cold sweat.

If you experience these symptoms, immediately call emergency services. If a heart attack is occurring, it is vital to get treatment as soon as possible to restore blood flow to the heart and prevent further damage to the heart.

The risk of acute coronary syndrome

People are more likely to experience ACS if they have certain risk factors. While some of these can’t be changed, such as a family history of heart disease or stroke, the following can:

Visit the risk factors page for more information.


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