Acute Coronary Syndromes

Acute coronary syndromes (ACS) refers to a spectrum of acute clinical manifestations of coronary artery disease. The hallmark of ACS is the presence of myocardial ischaemia caused by an abrupt reduction of coronary blood flow. Myocardial ischemia is the term we use when the heart muscle is starved of essential nutrient and this commonly leads to symptoms of chest pain (called angina).

Coronary Artery Disease (CAD) and its manifestations

CAD is due to a process called coronary atherosclerosis, which is an accumulation of fatty deposits in the coronary artery wall. As coronary atherosclerosis progresses, this leads to gradual narrowing of the coronary arteries that are responsible for supplying nutrient to the muscle of the heart. Although the exact mechanism is unknown, certain risk factors in a person increase the likelihood of atherosclerosis. These include smoking, diabetes mellitus, high blood pressure, high cholesterol and strong family history of premature CAD.

Once the narrowing in the arteries becomes critical, the amount of blood may not be able to meet the demand of the heart muscle. When angina occurs only on exertion, it is due to a stable narrowing (plaque) which only gives rise to symptoms when the de