Acute Coronary Syndrome

ExitCare ImageAcute coronary syndrome (ACS) is an urgent problem in which the blood and oxygen supply to the heart is critically deficient. ACS requires hospitalization because one or more coronary arteries may be blocked.

ACS represents a range of conditions including:

  • Previous angina that is now unstable, lasts longer, happens at rest, or is more intense.

  • A heart attack, with heart muscle cell injury and death.

There are three vital coronary arteries that supply the heart muscle with blood and oxygen so that it can pump blood effectively. If blockages to these arteries develop, blood flow to the heart muscle is reduced. If the heart does not get enough blood, angina may occur as the first warning sign.


  • The most common signs of angina include:

  • Tightness or squeezing in the chest.

  • Feeling of heaviness on the chest.

  • Discomfort in the arms, neck, or jaw.

  • Shortness of breath and nausea.

  • Cold, wet skin.

  • Angina is usually brought on by physical effort or excitement which increase the oxygen needs of the heart. These states increase the blood flow needs of the heart beyond what can be delivered.


  • Medicines to help discomfort may include nitroglycerin (nitro) in the form of tablets or a spray for rapid relief, or longer-acting forms such as cream, patches, or capsules. (Be aware that there are many side effects and possible interactions with other drugs).

  • Other medicines may be used to help the heart pump better.

  • Procedures to open blocked arteries including angioplasty or stent placement to keep the arteries open.

  • Open heart surgery may be needed when there are many blockages or they are in critical locations that are best treated with surgery.


  • Avoid smoking.

  • Take one baby or adult aspirin daily, if your caregiver advises. This helps reduce the risk of a heart attack.

  • It is very important that you follow the angina treatment prescribed by your caregiver. Make arrangements for proper follow-up care.

  • Eat a heart healthy diet with salt and fat restrictions as advised.

  • Regular exercise is good for you as long as it does not cause discomfort. Do not begin any new type of exercise until you check with your caregiver.

  • If you are overweight, you should lose weight.

  • Try to maintain normal blood lipid levels.

  • Keep your blood pressure under control as recommended by your caregiver.

  • You should tell your caregiver right away about any increase in the severity or frequency of your chest discomfort or angina attacks. When you have angina, you should stop what you are doing and sit down. This may bring relief in 3 to 5 minutes. If your caregiver has prescribed nitro, take it as directed.

  • If your caregiver has given you a follow-up appointment, it is very important to keep that appointment. Not keeping the appointment could result in a chronic or permanent injury, pain, and disability. If there is any problem keeping the appointment, you must call back to this facility for assistance.


  • You develop nausea, vomiting, or shortness of breath.

  • You feel faint, lightheaded, or pass out.

  • Your chest discomfort gets worse.

  • You are sweating or experience sudden profound fatigue.

  • You do not get relief of your chest pain after 3 doses of nitro.

  • Your discomfort lasts longer than 15 minutes.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.