Acute Coronary Syndromes – what are they?
Acute Coronary Syndrome or ACS is a broad term used for a range of conditions where blood flow through the coronary arteries is reduced by a partial or complete occlusion, leading to cardiac events such as angina or a heart attack and ultimately cardiac arrest.
ACS is a medical emergency that requires immediate attention.
Types of ACS
There are three main types of ACS:
- STEMI (ST-elevation myocardial infarction): A heart attack caused by a blockage of blood supply to an area of the heart. It is detected through abnormal changes in an electrocardiogram (ECG) and increased biochemical markers in the blood (troponin).
- Non-STEMI (non ST-elevation myocardial infarction): Usually a less severe heart attack resulting in limited damage to the heart. Changes may not be evident on ECG but key biochemical markers in the blood (troponin) will be elevated.
- Unstable angina: Angina is a type of pain or discomfort in the chest that is a symptom of poor blood flow through the coronary arteries. Unstable angina is any change from stable angina – where the chest pain occurs more often or increases in severity. It should be treated as seriously as a heart attack.
Causes and Risk Factors
The primary cause of ACS is the development of atheroma’s consisting of blood clots and cholesterol in coronary arteries, often due to atherosclerosis. This condition involves the buildup of plaque in artery walls, leading to narrowing of the arteries, restricted blood flow and potential clot formation. Atherosclerosis is the main underlying cause of cardiovascular disease.
Risk factors include smoking, high blood pressure, high cholesterol, obesity, diabetes, and inactive lifestyle. Other factors, like family history, cannot be changed but managed under medical supervision.
Symptoms, Diagnosis, Treatment
Common symptoms include: chest pain, shortness of breath, nausea, dizziness, and cold sweat. Immediate medical attention is crucial if you experience any of these symptoms.
Diagnosis: involves performing ECGs to detect electrical changes in the heart and blood tests for troponin levels, which will only rise 2-6 hours after heart muscle damage. The timing of these tests is important and these tests help decide the need for immediate unblocking of coronary vessels.
Treatment: focuses on restoring blood flow to the heart as quickly as possible to prevent further damage. This may require percutaneous coronary intervention ‘PCI’ e.g. coronary angiogram with stenting, dissolving of the clot via thrombolysis, medication to thin the blood or other medications to control cardiac risk factors or reduce stress on the heart.
If blood flow to the heart is disrupted or stopped, the heart’s electrical system may be affected causing an abnormal rhythm or cardiac arrest. In the case of a dangerous arrhythmia, immediate intervention such as electrical cardioversion or defibrillation is crucial to prevent death. If a cardiac arrest persists for longer than 20 minutes, the body will be starved of blood containing oxygen and it would be unlikely you will survive.
Additional Considerations
It is still possible to suffer a heart attack without experiencing any of the common symptoms or any ECG changes.
If ACS is not correctly diagnosed and treated in a time sensitive manner or left untreated the consequences may be catastrophic. Left untreated or delayed treatment may lead to permanent damage to the heart resulting in a heart attack that can be fatal, heart failure that can severely limit your lifestyle and cardiac arrhythmias that can cause sudden losses of consciousness, shortened life expectancy and even sudden death.
Coronary artery disease is progressive and without appropriate treatment will increase the frequency of chest pain, heart attacks and risk of cardiac arrest.
Patients who suffer from certain heart attacks called STEMI require immediate intervention. This is why timely diagnosis and review by appropriately trained health professionals is vital! Expeditious PCI may prevent cardiac arrest and limit the damage to the heart.
Failure to treat every episode of chest pain as a medical emergency with time critical blood tests and ECGs with appropriate medical review may result in a missed diagnosis of ACS or even a heart attack with potentially devastating or even fatal consequences.
Chest pain with normal ECGs and blood tests may also require further tests to exclude coronary artery disease, namely exercise stress tests, stress echocardiograms, thallium stress test, CT coronary angiograms or percutaneous coronary angiogram. Failing to exclude coronary disease with these tests can have severe consequences.
How we can help
If you, or a loved one, were not treated appropriately after having suffered ACS you may have an action for negligence against the hospital and/or medical practitioner. That is where our experienced and passionate team can help provide expert legal advice and support to assess your rights and pursue a claim for compensation.
DISCLAIMER
This article reflects the current law at the time of publication. It is intended for informational purposes only and does not constitute legal advice. The actual decisions in each case are summarised for general understanding. For specific legal guidance in relation to your situation, please consult with a qualified legal professional.
