Acute Coronary Syndrome

Alberto Foschi, MDCardiology DepartmentSaint Francis Hospital

Acute Coronary Syndrome

What does this mean?

• Acute– “All of the sudden” event

• Coronary– Involves arteries of the heart

• Syndrome

– Symptoms and signs

Agenda

• Risk factors

• Presentation

• Diagnosis

• Treatment

• Recovery

Risk FactorsControllable

• Diabetes

• Hypertension

• Obesity

• Smoking

• High cholesterol

• Metabolic syndrome

• Stressful events

Uncontrollable

• Family history

• Age

• Genetic sex

Presentation

• Chest Pain

– Center of chest

– May radiate to arm or jaw

Presentation

• Shortness of breath– Heart doesn’t receive enough blood

Presentation

• Palpitations– Extra beats

Presentation

• Cold Sweat

• Perspiration

Presentation

• Faint Feeling

Presentation

• Nausea or vomiting

Diagnosis

• Call 911 for emergency attention

• Emergent electrocardiogram

• Transfer to Chest Pain Center for treatment and confirmation of diagnosis

• “Time is muscle”– Act quickly

Treatment

• Drugs for symptom relief

– To treat pain

– To alleviate shortness of breath

• Immediate angiogram and angioplasty (if done in under 90 minutes of onset of symptoms)

– Reduces mortality significantly

• Rule of 10 to 1

– Every 10 minutes saved decreases mortality by 1%

Recovery

• Aggressive correction of all risk factors

• Cardiac rehabilitation program

Actual Angiogram

Angiogram shows complete

blockage

Actual Angiogram

This shows the expansion of

the stent by the balloon

Actual Angiogram

The final picture of the

angiogram after the

coronary stent placement.