Acute coronary syndromes (ACS) is a term used to describe a group of conditions resulting from acute myocardial ischemia (insufficient blood flow to heart muscle) and ranging from unstable angina (increasing, unpredictable chest pain) to myocardial infarction (heart attack). The conditions are related to varying degrees of narrowing or blockage of single or multiple coronary arteries that provide blood, oxygen, and nutrients to the heart. This life-threatening disorder is a major cause of emergency medical care and hospitalization. Coronary artery disease (CAD) remains the leading cause of death in the United States. One of every 5 deaths is due to CAD, accounting for more than 452 000 deaths in 2006. The August 15, 2007, issue of JAMA includes an article indicating that diabetes is a significant risk factor for ACS and adds to the overall burden of cardiovascular disease. This article highlights the importance of aggressive strategies to treat diabetes in patients with heart disease.
Chest pain—uncomfortable pressure, squeezing, or fullness
Upper body discomfort—pain or discomfort in both arms, the back, neck, jaw, or abdomen
Shortness of breath
Other symptoms include sweating, nausea, and light-headedness
If you or someone you are with has chest pain, especially with one or more of these other symptoms or signs, call 911 in the United States or the number for medical emergencies in other locations. Acute coronary syndrome patients can benefit from immediate medical care. If cardiac arrest occurs (loss of responsiveness, no sign of breathing, no heartbeat or pulse), call 911 immediately and start CPR (cardiopulmonary resuscitation).
Initial assessment includes a complete medical history, physical examination, an electrocardiogram (ECG) test to evaluate the electrical activity of the heart, and blood tests to evaluate the presence of chemicals resulting from cardiac cell injury. Hospitalization may be necessary. Standard treatments for coronary artery blockage may include placement of stents (mesh tubes) within narrowed blood vessels or heart surgery for bypass grafting of blocked vessels.
Control your blood pressure
Exercise on a regular basis
Eat a healthful diet
Maintain a reasonable body weight
Ask your doctor about taking a low dose of aspirin each day
American Heart Association (AHA)http://www.americanheart.org
American College of Cardiologyhttp://www.acc.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on coronary artery disease was published in the November 24, 2004, issue; one on percutaneous coronary intervention was published in the February 11, 2004, issue; and one on cardiac arrest was published in the January 4, 2006, issue.
Sources: American College of Cardiology, American Heart Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: HEART DISEASE
Zeller JL, Burke AE, Glass RM. Acute Coronary Syndromes. JAMA. 2007;298(7):828. doi:10.1001/jama.298.7.828