Acute coronary syndrome (ACS) occurs when a blood clot suddenly forms within a coronary artery. This usually happens when a plaque ruptures in the wall of the artery. The blood clot produces a sudden blockage of the artery, leading to ischemia (insufficient blood flow to the heart muscle).
The severity of ACS syndrome depends on whether the blood clot completely or only partially blocks the artery, and how long the clot lasts. (The body's protective mechanisms try to dissolve blood clots that form within blood vessels. Read more about how the blood clots here.) Clots that completely block an artery often cause myocardial infarction or even sudden death. Clots that only partially block an artery, or that persist for only a few minutes, produce unstable angina. In either case, ACS is a medical emergency.
Anyone with CAD can develop ACS. So everyone with CAD should take appropriate steps to reduce the risk of ACS. These preventative actions include steps to lower the risk of plaque rupture, and steps to reduce the risk of large or persistent blood clots if a rupture occurs.
Accordingly, if you have CAD you should do the following things:
- Stop smoking. You should think of smoking as a technique for actively irritating plaques within your coronary arteries. Even one cigarette can acutely increase the risk of ACS for up to a day or two. And when you quit smoking, your risk of ACS drops substantially within a few days.
- Ask your doctor about statin therapy. Statins can help to stabilize plaques to help keep them from rupturing. Statins also improve the function of the lining of arteries, reduce inflammation, and reduce blood clot formation -- all of which can help to prevent ACS.
- Make sure your blood pressure is normal blood pressure. High blood pressure increases the risk of plaque rupture.
- Ask your doctor about taking beta blockers. Beta blockers can help prevent plaque rupture by limiting the effect of stress and exertion on the blood vessels.
- Make sure your cholesterol measurements are adequate. High LDL cholesterol and low HDL cholesterol levels are thought to increase the risk of plaque rupture.
- Ask your doctor about taking aspirin. Aspirin therapy reduces the "stickiness" of blood platelets, and can reduce blood clot formation when plaque rupture occurs.
Taking these steps will go a long way toward preventing ACS.
You can read more about the treatment of CAD here.
Sources
Anderson, J, Adams, C, Antman, E, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 2002 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction): developed in collaboration with the American College of Emergency Physicians, American College or Physicians, Society for Academic Emergency Medicine, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2007; 50:e1. Available at: http://content.onlinejacc.org/cgi/content/full/50/7/e1 (accessed September 12, 2008).
Ryan, TJ, Antman, EM, Brooks, NH, et al. 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: Executive summary and recommendations. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). Circulation 1999; 100:1016.
