What is acute coronary syndrome?
Acute coronary syndrome is a sudden circulatory disorder in the coronary arteries. It is usually arteriosclerotic deposits that block one or more vessels. Less commonly, blood clots are the cause of a lack of blood supply to the heart.
“The mildest form of acute coronary syndrome is unstable angina pectoris. Heart attack is one of the more serious courses,” explains Professor Oliver Ritter, clinical director of the University Clinic for Cardiology, Nephrology and Pulmonology at the Brandenburg Hospital and member of the Scientific Advisory Board of the German Heart Foundation eV
What heart diseases does acute coronary syndrome include?
In angina pectoris, the vessels in the heart narrow due to deposits called plaques. Blood flow is increasingly restricted. Those affected initially feel this under physical strain, for example when climbing stairs. There is pain, pressure, burning and tightness in the chest and you quickly become out of breath. When the strain stops, the pain disappears.
In a heart attack, on the other hand, an acute complete occlusion of a coronary artery occurs. This is usually the result of increasing calcification of the vessels (arteriosclerosis) that has existed over many years. Doctors speak of coronary heart disease. “The heart attack is usually caused by such arteriosclerotic blockage,” explains Ritter. “Since the region of the heart in which the heart attack occurs is no longer supplied with blood and oxygen, a heart attack is always a life-threatening emergency.”
Acute coronary syndrome: symptoms you should take seriously
If you notice that you are suddenly out of breath during usual physical activities, or if you experience pain, pressure and burning in your chest when you exert yourself, you should see a cardiologist and have your heart examined. In a heart attack, the symptoms appear suddenly and persist: There are severe belt-shaped pains in the chest, breathing difficulties and even shortness of breath, fear of death, dizziness and sweating.
“It is also possible that a heart attack manifests itself through unspecific symptoms such as nausea, upper abdominal pain, neck or jaw pain ,” says the expert. “It depends on the type of heart attack. With an anterior wall infarction, severe chest pain is typical. With a posterior wall infarction, upper abdominal complaints, neck and jaw pain are more likely to occur.”
When it comes to a heart attack, every minute counts
If you suspect a heart attack, you should not hesitate to call the emergency number on 112. The diagnosis of acute coronary syndrome can be made with the help of blood tests, ultrasound and catheter examinations. “Act quickly. Hesitation significantly worsens the chances of survival. Cardiac arrhythmias occur , there is a risk of sudden cardiac death,” warns Ritter, referring to the current corona pandemic, which has made many people afraid to go to the hospital. “Many endured the symptoms for too long – and didn’t survive.”
However, if treated quickly in hospital, the chances of survival are good. According to the cardiologist, if the patient is awake, responsive and has stable circulation, the chances of survival are almost 100 percent. If you lose consciousness before the emergency doctor arrives, it is important that first aiders carry out resuscitation measures, i.e. cardiac pressure massage, so that the body and especially the brain are adequately supplied with oxygen. “Without courageous first aiders, the patient dies after about ten minutes,” says Ritter.
Treating acute coronary syndrome: Catheter technology saves lives
In the case of a severe heart attack, the catheter examination must be carried out within an hour of the onset of symptoms. If the symptoms are less severe, the doctors have longer time. In almost 100 percent of cases, the patient has a stent placed. The small metal tube opens the closed vessel, allows the blood to flow again and also prevents the vessel from closing again.
Open, surgical intervention on the heart is rare for an acute heart attack. It is necessary, for example, if vessels are affected that the doctor cannot reach with the catheter or if several vessels need to be treated at once.
Acute coronary syndrome: This is what happens after the hospital
In the case of an acute coronary syndrome such as a heart attack, patients usually stay in the hospital for five days – provided the treatment goes without complications. You will then receive further care for around three weeks as part of rehabilitation. This includes, among other things, stress tests, nutritional training, support in quitting smoking, sporting activities and psychological support.
“The real work comes after the rehab,” explains Ritter. “Every patient is then encouraged to maintain a healthy lifestyle and take their medication properly in order to prevent another heart attack.” In addition to medications that inhibit blood clotting (antithrombocytic therapy), heart attack patients usually also have to take cholesterol-lowering and antihypertensive drugs as part of long-term therapy.
Prevent acute coronary syndrome: This is what you can do
If you want to prevent acute coronary syndrome, you should ensure that your vessels remain healthy and avoid risk factors that lead to deposits and calcification. A healthy lifestyle is the be-all and end-all here. Experts recommend:
- Eat healthy and balanced. The heart particularly benefits from the Mediterranean diet.
- Get enough exercise. Endurance sports in particular strengthen the heart. Be active three hours a week.
- Do not smoke.
- Avoid being overweight.
- If you have type 2 diabetes mellitus (diabetes), make sure that your blood sugar levels are well controlled.
- Have your blood lipid levels checked regularly.
- Keep an eye on your blood pressure values.