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Acute coronary syndrome | Spain| PDF | PPT| Case Reports | Symptoms | Treatment

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Acute Coronary Syndrome

  • 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


    The signs and symptoms may vary depending on your sex, age and whether you have an underlying medical condition, such as diabetes, heart attack.

    Some additional heart attack symptoms include:

    Abdominal pain

    • Pain similar to heartburn

    • Clammy skin

    • Lightheadedness, dizziness or fainting

    • Unusual or unexplained fatigue


    • Acute coronary syndrome is most often a complication of plaque buildup in the arteries in heart

    • Blood clots in blood streams (embolism)

    • Cigarette smoking

    • Lack of physical activity

    • Type 2 diabetes

    High blood pressure

    • High blood cholesterol

  • Acute coronary syndrome

     Tests and diagnosis


    Blood tests

    Chest X-ray

    Nuclear scan

    Coronary angiogram(cardiac catheterization)

    Computerized tomography (CT)angiogram

    Exercise stress test

    Treatments and Drugs

    Medications include

    • Aspirin

    • Thrombolytics

    • Nitroglycerin

    • Beta blockers

    • Angiotensin-converting enzyme (ACE) inhibitors

    • Angiotensin receptor blockers (ARBs)

    • Calcium channel blockers

    • Cholesterol-lowering drugs

    • Clot-preventing drugs

    Surgery and other procedures

    • Angioplasty and stenting

    • Coronary bypass surgery

  • Acute coronary syndrome


    A Population-based longitudinal cohort conducted in Finland and Spain, and comprising 12 231 consecutive ACS patients admitted in 53 hospitals between 2008 and 2010. Baseline characteristics, clinical management and inhospital outcomes were recorded. Contextual effect of country on death was analysed through multilevel analysis. Of all patients included, 8221 (67.2%) had NSTEMI (non-ST-elevation myocardial infarction), and 4010 (32.8%) had STEMI (ST-elevation myocardial infarction). Inhospital mortality ranged from 15.1% to 4.9% for German and Spanish STEMI patients, and from 6.8% to 1.9% for Finnish and French NSTEMI patients (p<0.001 for both). These international variations were explained by differences in patients' baseline characteristics (older patients more likely to have cardiogenic shock in Germany) and in clinical management, with differences in rates of thrombolysis (less performed in Germany) and primary percutaneous coronary intervention (high in Spain, low in Greece). A remaining contextual effect of country was identified after extensive adjustment.

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