Acute coronary syndrome

What is acute coronary syndrome?

Acute coronary syndrome describes a range of heart conditions in which blood supply to the heart muscle is suddenly blocked or reduced. It can include heart attack, unstable angina, and stroke, as well as other life-threatening heart conditions. In most cases, blood flow is blocked by a blood clot or build-up of plaque.

Prof. Dion Stub is a leading interventional cardiologist providing diagnosis and treatment for acute coronary syndrome from hospitals across Melbourne.

Causes & risk factors

Factors such as age, weight, and family history of heart conditions can increase your chances of developing acute coronary syndrome. Lifestyle factors – including smoking, excessive drinking, unhealthy diet, and lack of exercise – can also contribute to its development.

Some recent research has shown that previous COVID-19 infection may put you at a higher risk.


Symptoms can include:

  • Nausea
  • Dizziness and lightheadedness
  • Chest pain or discomfort (often severe)
  • Pain in the jaw, neck, back, or stomach
  • Chest pressure when resting
  • Unexplained fatigue
  • A sense of impending doom or dread

Why is acute coronary syndrome dangerous?

The condition is a medical emergency which needs immediate care. It causes reduced blood flow to the heart which can lead to heart tissue death. This can permanently reduce your heart’s ability to function and put you at higher risk for other heart conditions in the future.

Even if it does not cause cell or tissue death, the condition changes how your heart works and can put you at high risk of heart attack.


Your cardiologist needs to locate the blockage and identify the cause before they can diagnose acute coronary syndrome and recommend a course of treatment. Since acute coronary syndrome is a cardiac emergency, these tests may be done in an emergency room.

  • ECG – this measures the heart’s electrical activity and detects irregular impulses. Certain patterns may confirm a blockage or show its approximate location.
  • Blood tests – certain enzymes can appear in your blood if your heart has suffered damage. A blood test can detect these to determine whether cell death has occurred.
  • Coronary angiography – a cardiologist uses a small catheter to inject x-ray dye into your arteries, which allows them to gain a clear image of your heart’s blood vessels and identify any blockages.
  • Stress test – this measures your heart’s performance when you exercise and may be performed if a regular ECG can’t detect your heart problem accurately. It is only done if there are no signs of a life-threatening heart condition while you are at rest.


Acute coronary syndrome is treatable if diagnosed quickly. Treatments generally focus on re-opening the blocked artery as soon as possible, and will usually take place in a hospital setting. Your treatment may include one or more of the following:

  • Angioplasty and stenting – this is a minimally invasive procedure which involves placing a small mesh tube (stent) inside a blocked artery to push it open. Blood can then pass through it easily and deliver oxygen to the heart muscle.
  • Medications – drugs may be used to thin the blood, widen blood vessels, and help dissolve clots, especially if the hospital is not equipped to perform angioplasty in an emergency. They may also be used afterward to lower the changes of a repeat episode.
  • Bypass surgery – a cardiologist may graft a new section of blood vessel to a coronary artery containing a clot. This restores blood flow by creating a new route for blood to flow through freely.

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