Acute Coronary Syndrome

 Acute coronary syndrome is a term used for any condition brought on by sudden, reduced blood flow to the heart. Acute coronary syndrome symptoms may include the type of chest pressure that you feel during a heart attack, or pressure in your chest while you're at rest or doing light physical activity (unstable angina).

Typical symptoms

• Chest pain (angina) that feels like burning, pressure or tightness, Pain elsewhere in the body, such as the left upper arm or jaw (referred pain), Nausea, Vomiting, Shortness of breath (dyspnea),heavy sweating (diaphoresis).

Tests and diagnosis

Electrocardiogram (ECG), Blood tests, Echocardiogram, Chest X-ray, Nuclear scan, Coronary angiogram (cardiac catheterization), Computerized tomography (CT) angiogram, Exercise stress test.

 Statistics

The registry is carried out in cooperation with the Ministry of Health and the National Health Fund. The initial diagnoses were unstable angina in 42.2%, NSTEMI in 26.6%, and STEMI in 31.2% of patients. About one-third of patients were treated outside of cardiology departments (mainly in the internal medicine wards). In patients without ST elevation, invasive strategy (early coronary angiography) was used with almost equal frequency in unstable angina (29.4%) and NSTEMI (31.7%). However, in-hospital mortality was low in unstable angina (0.8%), being much higher in NSTEMI patients (6.6%), (p<0.001). In STEMI reperfusion therapy was administered in 63.3% of patients (thrombolysis 7.8%, primary PCI 54.1%, and PCI after thrombolysis 1.4%). In-hospital mortality in STEMI was 9.3%. Median times from the onset of symptoms to invasive treatment were: 37 hours in unstable angina, 23 hours in NSTEMI, and 5 hours in STEMI. The guidelines' recommended pharmacotherapy was used in a high percentage of patients except for thienopyridines and GP IIb/IIIa inhibitors.