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Acute Coronary Syndrome

Acute coronary syndrome is a serious medical condition and requires immediate medical attention. Anyone who experiences an acute onset of chest pain, fullness, discomfort or pressure; shortness of breath; fatigue; experiences nausea, vomiting or lightheadedness should call 911 immediately. The acute onset of these symptoms could indicate the early stages of a heart attack or another cardiac-related condition.

Acute coronary syndrome (ACS) is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart from the coronary artery blockage. The blockage can be sudden, or it may come and go over a period of time. If oxygen supply to the heart becomes too low, the cells of the heart muscle can die, which can lead to a heart attack. If the cells do not die, damage due to an inadequate supply of oxygen can lead to the heart muscle not working correctly or efficiently, this can result in congestive heart failure. The location of the blockage, the length of time the blood flow is reduced, and the amount of damage determines the type of ACS.

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Causes of Acute Coronary Syndrome

The main cause of ACS is due to the obstruction of the blood vessel, typically caused by a blood clot. However, there are certain traits, conditions or habits may raise your risk for the disease. These conditions are known as risk factors.

Non-Modifiable Risk Factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing ACS.

  • Older age – men of 45 years or older, women aged 55 years or older.
  • Family History/genetics

Modifiable Risk Factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

  • High blood pressure
  • High cholesterol
  • Little to no physical activity.
  • Obesity or having a body mass index “BMI” of 30 or greater.
  • Long history of cigarette smoking and/or drug abuse.
  • Extreme emotional stress.
  • Excessive amounts of alcohol consumption over many years.

Symptoms of Acute Coronary Syndrome

The signs and symptoms of ACS generally begin quickly, sometimes without warning, and can alert a person that something is wrong. Some of the most common symptoms include:

  • Chest pain, fullness, discomfort or pressure.
  • Discomfort or pain in one or both arms, the back, neck, jaw or stomach.
  • Lightheadedness/Fainting
  • Fatigue
  • Rapid heart rate (tachycardia) of over 100 beats per minute.
  • Heart palpitations
  • Shortness of breath
  • Nausea and/or vomiting
  • Sweating

Diagnosis of Acute Coronary Syndrome

To make a quick and accurate diagnosis, a doctor will perform tests as well as inquire about any symptoms and previous medical history. Diagnostic tests and procedures may include one or more of the following:

Treatment of Acute Coronary Syndrome

If you've been diagnosed with ACS, making healthy lifestyle changes can help prevent or delay serious health problems. Some treatment options include lifestyle changes and medications.

Lifestyle Changes

  • Avoid smoking.
  • Eat a heart-healthy diet, especially low-fat diet.
  • Exercise under the directions of your doctor.
  • If you’re overweight, talk to your doctor about weight loss options.
  • If applicable, ask your doctor more information on diabetes management.
  • Make and keep appointments to see your doctor for routine checkups and follow-up tests.


  • ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure.
  • Angiotensin II receptor blockers will help blood vessels open up, leading to a lower blood pressure.
  • Beta blockers will help reduce your blood pressure.
  • Alpha blockers will help reduce the arteries’ resistance, relaxing the muscle tone of the vascular walls.
  • Alpha-2 receptor agonists will help reduce blood pressure by decreasing the activity of the sympathetic portion of the involuntary nervous system.
  • Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
  • Central agonists will help decrease the blood vessels’ ability to tense up or contract.

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Cooperman Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900

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