The main cause of acute coronary syndrome (ACS) is a blockage or obstruction in coronary arteries. This blockage is commonly caused by a cholesterol-rich plaque, often referred to as a thrombus. A plaque may show abnormalities in heart activity on the electrocardiogram. Common symptoms if ACS may manifest as shortness of breath or chest pain.
ACS is a significant health concern due to the morbidity and mortality associated with it. Physicians may consider a patient’s cardiac biomarkers, electrocardiography findings, and the history and symptoms of a patient. The primary goal of treatment is to rapidly restore blood flow surrounding arterial blocks (rapid reperfusion) and treat the narrowing of coronary arteries (primary percutaneous coronary intervention).
In terms of preventive strategies, professional guidelines by the American College of Cardiology (ACC) and American Heart Association (AHA) uphold decreasing risk factors including diabetes mellitus, hypercholesterolemia, hypertension, and smoking.
Aspirin is generally the first line of treatment. Recommended therapies include dual antiplatelet therapy, and the use of anticoagulants, beta blockers, angiotensin receptor blockers, and angiotensin-enzyme converting inhibitors. Reperfusion therapy may be administered in eligible cases. Common Symptoms of Acute Coronary Syndrome
To confirm a diagnosis of acute coronary syndrome, your physician may check the presence of obvious symptoms:
Pharmacological Approaches for Acute Coronary Syndrome
Several diagnostic tests are associated with ACS. You may be asked to undergo one or more tests from the list indicated below:
Surgical Interventions Your doctor may recommend one of the following procedures to restore blood flow to your heart muscles:
Angioplasty and stenting procedures - During this surgery, the doctor inserts a catheter or long and thin tube into the blocked or narrowed portion of your artery. A wire with a deflated balloon is conveyed to the narrowed region via the catheter. By compressing the plaque deposits against your artery walls, the balloon is then inflated, expanding the artery. There is normally a mesh tube (stent) left in the artery to help hold the artery intact.
Surgery for coronary bypass - A surgeon takes a piece of the blood vessel (graft) from another part of the body and establishes a new blood path that goes through (bypasses) a blocked coronary artery.
Effects of the COVID-19 Pandemic on Acute Cardiology Care
Inpatient treatment and bed redistribution has undergone a massive shift, with many wards converted into units for handling COVID-19 situations. COVID-19 has been a major influence, especially on inpatient cardiology and the length of stay of acute cardiology patients. ICUs, being occupied by critical COVID-19 cases can no longer accommodate cardiothoracic surgery patients or acute cardiology patients.
COVID-19 also tends to increase the number of false positives related to ACS as the condition may present ECG changes and clinical myopericarditis syndrome mimicking ACS. 18% - 23% COVID-19 patients exhibit troponin elevation, even in the absence of chest pain. About 7% COVID-19 deaths may be traced to fulminant myocarditis. Fulminant myocarditis (FM) is a fatal cardiac condition that results due to a rapid decline in cardiac function. FM may be diagnosed using a number of techniques including echocardiography, cardiac magnetic resonance, and others.
A drop in ACS cases post-pandemic may not necessarily be true as it may reflect the reluctance of patients attending the hospital. Another important impact of the COVID-19 crisis is on the healthcare workers offering cardiology services, more so those related to aerosol-generating procedures, or the ones involved in ambulance transport, echocardiography, and urgent percutaneous procedures. How KareOptions Can Help if you are Dealing with ACS
KareOptions is the right destination for seeking an optimal diagnosis and treatment plan. Given the inherent complexities involved in dealing with ACS, KareOptions focuses on second opinion as your best route to a convincing plan of recovery. Our Medical Second Opinion Service (MSOS) and Second Opinion Board Review (SOBR) focuses on offering the best specialists in cardiac care to help you understand your possible options and support you through your treatment journey. We also offer end-to-end care coordination through our Continuity of Care (COC) and Transfer of Care Coordination (TOCC) services.
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