Acute coronary syndrome

04 May 2024
Acute coronary syndrome

Acute coronary syndrome is any group of clinical signs or symptoms suggesting acute myocardial infarction (death of cardiac muscle cells due to impaired blood flow in this area) or unstable angina (a variant of acute myocardial ischemia, the severity and duration of which is insufficient for the development of myocardial infarction).

Symptoms of the acute coronary syndrome

The main symptom of acute coronary syndrome is pain:
- by nature - compressive or pressing, often there is a feeling of heaviness or lack of air;
- localization of pain - behind the breastbone or in the atrial region, i.e. on the left side of the sternum;
- the pain passes into the left arm, the left shoulder or both arms, neck area, lower jaw, between the scapulae, the left subscapular region;
- duration - more than 10 minutes;

Causes of the acute coronary syndrome

Sudden violation of the blood supply to the heart muscle, which arises from a mismatch between the supply of oxygen to the myocardium and the need for oxygen, is the direct cause of the development of acute coronary syndrome. This happens for the following reasons:
- Arteriosclerosis of the coronary arteries – is a chronic disease characterized by densification and loss of elasticity of artery walls, narrowing of their lumen due to so-called atherosclerotic plaques.
- Thrombosis of the coronary arteries, which occurs when an atherosclerotic plaque is detached from the body - a formation consisting of a mixture of fats, primarily cholesterol (a fatty substance that is a "building material" for body cells) and calcium - which can be found in any vessel of the body, and transferring it with the blood flow into the coronary artery.

Treatment of the acute coronary syndrome

Treatment of patients with acute coronary syndrome in each individual case depends on the risk of developing myocardial infarction (death of cardiac muscle cells due to blood flow disorders in this area) or death and is selected strictly individually.

Basic principles of treatment:
- Strict bed rest.
- Inhalation of oxygen through a mask or nosepiece.
- Adequate anesthesia (used as non-narcotic and narcotic analgesics (painkillers)).
- Desaggregants (drugs that reduce the ability of platelets (blood cells responsible for blood clotting) to gluing). Antithrombotics (reducing thrombus formation (formation of blood clots in blood vessels) and promoting thrombus dissolution).
- Fibrinolytics (thrombolytics) - cause destruction of the formed filaments of fibrin (protein, which is the final product of the process of blood coagulation); They contribute, in the main, to resorption of fresh blood clots; Are effective for patients with myocardial infarction, as they make it possible to reduce intracoronary thrombosis and significantly increase the survival of patients.
- Statins are drugs for the stabilization of atherosclerotic plaque (a formation consisting of a mixture of fats (primarily cholesterol (a fatty substance that is a "building material" for body cells) and calcium).