Acute Coronary Disease

Acute coronary disease is better known as acute coronary syndrome. Whichever name one uses, the phrase describes either severe chest pain or a heart attack in which the heart stops working properly because the muscle becomes starved of oxygen-rich blood. Acute coronary syndrome produces the classic symptoms of a heart attack and can be treated with several medications and surgeries. People can reduce their risk by leading a healthy lifestyle.

Cause

• Acute coronary syndrome can strike when plaque that has accumulated in a coronary artery breaks free and blocks the flow of blood into the heart. Patients whose coronary arteries have become completely clogged with plaque can also experience acute coronary syndrome. Plaque consists of cholesterol, triglycerides and other forms of fat that have stuck to the artery walls over time.

Heart Problems Described as Acute Coronary Syndrome

• As noted, the term "acute coronary syndrome" or "acute coronary disease" describes more than one heart problem. The first condition falling under the acute coronary syndrome rubric is unstable angina. People who experience unstable angina have usually suffered stable angina for some period, feeling chest pain and tightness and becoming short of breath when engaging in physical activity. With unstable angina, the symptoms become more intense and occur even though the patient is not exerting himself. Acute coronary syndrome also describes two types of heart attacks---non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction. The ST segment is the part of the heartbeat during which both ventricles, or lower chambers, of the heart have the same electrical charge. The ST segment increases in length (i.e., becomes elevated) the longer the heart goes without an adequate supply of blood.

Symptoms

• Burning pain and extreme tightness in the chest are the principal symptoms of acute coronary syndrome. The pain can travel into a patient's upper arms and jaw and be accompanied by nausea, sweating, lightheadedness and difficulty breathing.

Drug Treatments

• An online brochure from the Mayo Clinic lists numerous drug treatment options for acute coronary syndrome. One of the most effective medications is aspirin, which thins blood and helps keep it flowing through plaque-clogged coronary arteries. Patients requiring additional treatment to prevent blood from backing up behind plaque can receive heparin, warfarin (e.g., Coumadin from Bristol Myers Squibb) or a drug known as a thrombolytic such as clopidogrel (e.g., Plavix from Sanofi-aventis). Nitroglycerin relieves angina symptoms, and medications classified as beta blockers such as carvedilol (e.g., Coreg from GlaxoSmithKline) and metoprolol (Toprol XL from AstraZeneca) lower the tension across the heart muscle. To reduce and prevent the growth of plaque in arteries, patients can receive any of a number of cholesterol-lowering medications. Pharmaceutical options for lowering cholesterol include enalapril (e.g., Vasotec from Biovail), lisinopril (e.g., Zestril from AstraZeneca), losartan (e.g., Cozaar from Merck) and valsartan (Diovan from Novartis).

Surgical Treatments

• Patients with a coronary artery only partially blocked by plaque can benefit from angioplasty. Angioplasty involves inserting a balloon into the coronary artery, inflating it to flatten plaque against the artery wall and then withdrawing the balloon. Surgeons may implant a cage-like device known as a stent into the artery after performing an angioplasty to both hold the blood vessel open and keep the plaque firmly against the artery wall. When an artery has become completely blocked, patients need a coronary artery bypass, which involves taking a small piece of an artery from another part of the patient's body---usually the leg---and attaching that new piece to the aorta and the heart. The blocked coronary artery gets removed during a bypass surgery.

Prevention

• Reaching 45 years of age automatically increases a person's risk for acute coronary syndrome. Individuals can control every other leading risk for the condition. By stopping smoking, exercising regularly, drinking alcohol only in moderation and maintaining healthy weight, people greatly reduce their likelihood for experiencing acute coronary syndrome and for developing health problems such as hypertension and diabetes that themselves raise people's risk for acute coronary syndrome.