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The blockage can be sudden and complete, or it can come and go clot, break open, then clot again. In
either case, the heart tissue is dying, even if its just a few cells or a whole big section of the heart, Bolger
said.
Doctors use the broad term regularly, but usually only among themselves and in the medical literature.
Its like describing a North American state rather than just saying Texas, Bolger said. I dont think too
many doctors say, Youre having an acute coronary syndrome. They say, Youre having a heart attack.
These symptoms should be taken seriously. If you experience chest pain or other symptoms, call 9-1-1
immediately. People are in denial and theyre sitting there thinking, This cant really be happening to
me, Bolger said. We want them to feel entitled to call 9-1-1. Theyre not being alarmist.
Chest pain caused by acute coronary syndromes can come on suddenly, as is the case with a heart attack.
Other times, the pain can be unpredictable or get worse even with rest, both hallmark symptoms
of unstable angina. People who experience chronic chest pain resulting from years of cholesterol buildup
in their arteries can develop an acute coronary syndrome if a blood clot forms on top of the plaque
buildup.
How is it diagnosed and treated?
To determine whats causing your symptoms, a doctor will take a careful medical history and give you a
physical examination. If the doctor suspects an acute coronary syndrome, the following tests will be
performed:
A blood test can show evidence that heart cells are dying.
An electrocardiogram (ECG or EKG) can diagnose an acute coronary syndrome by measuring the
hearts electrical activity.
If tests confirm blood flow to the heart has been blocked, doctors will work quickly to reopen the artery.
Minute by minute, the heart is accumulating irreversible damage. So time is myocardium myocardium
being the heart muscle itself, Bolger said.
At San Francisco General Hospital, the goal is to have the artery reopened within an hour of the patient
entering the hospital, Bolger said. Generally, patients do best when the artery is reopened within four
hours of the first symptoms.
Am I at risk?
Acute coronary syndromes, just like heart failure and stroke, are much more likely in people who have
certain risk factors. These include:
Smoking
High blood pressure
High blood cholesterol
Diabetes
Physical inactivity
Being overweight or obese
A family history of chest pain, heart disease or stroke
ACUTE CORONARY SYNDROME
( ACS )
ICU AREA