Acute Coronary Syndrome Types and Diagnosis [ 0 Comments ] [ August 2, 2016 ]

This is less a single disease, and more of a spectrum of group of conditions. They do have one thing in common, the decreased flow of blood in the arteries. Two most common types of ACS are unstable angina and myocardial infarction.

Being able to identify this condition is a valuable skill for medical professionals, and can be learned in ACLS classes in San Diego County at the Advanced Healthcare Education facilities all over the County.


The most obvious and common symptom is chest pain. It is described by the sufferers as pressure which radiates towards the left arm or the jaw. It may be accompanied by shortness of breath, nausea and sweating, as well as vomiting. Some sufferers report palpitations and anxiety as well, or even no physical symptoms at all (more related to diabetes sufferers). Sadly, since none of these symptoms are unique to the ACS, they are inconclusive as a diagnostic tool. Further tests need to be conducted.


There are several tools that can help with the diagnosis of these dangerous conditions.


The most accurate of the tests for diagnosing the chest pain, it is often the first test done to the patient with the symptom. It can even be done in the ambulance, and it can indicate acute heart damage, which identifies the illness as a heart attack, and immediate action is taken. Depending on the condition it can either be in the form of a thrombolytic, a medication which breaks down the blood clots; or the angioplasty, which is an invasive procedure where a catheter is inserted into the patient’s bloodstream to identify and repair the obstruction. If the ECG reveals no discernible data, the next step is taken.

Blood works and Imaging

Since chest pain can be indicative of many things, a fairly broad spectrum of tests is conducted on the patient. Chest x-rays are typical, but telemetry is also a possibility. Of course, full blood test is done as well. A part of the blood test is looking for markers for myocardial infarction. There are actually several markers which could indicate a myocardial infarction.

Types of ACS

There are three distinct types of ACS, both in the identification and in treatment.

ST elevating myocardial infarction is a typical heart attack. In electrocardiography, the ST segment should be a part of no charge, meaning there should be no elevation in the graph. However, in this type of illness, the elevation is present. The diagnosis and the treatment have been described above. The recommendation of the AHA and other relevant medical institutions is to perform the treatment as quickly as possible, with recommended time being under 30 minutes.

Non ST elevating myocardial infarction is the less-typical heart attack. It does not involve the elevation of the ST segment, but it still includes some sort of blockage in the arteries. Treatment for such type of ACS is aspirin. There are other types of medications acceptable as well, such as platelet inhibitors. If the pain does not subside, opioids are used. Another blood test is done after 12 hours, to check for myocardial markers. If positive, angioplasty is performed to preclude the possibility of a full-on heart attack in the near future.

Unstable angina differs from the stable one in terms of its onset. While stable angina only manifests at peak exertion, unstable angina occurs at rest, or at low exertion. In terms of symptoms it is not easily distinguished from Non ST elevating myocardial infarction. The only way to determine which of the two conditions is present is through blood tests. The myocardial markers are elevated in the case of NSTEMI, while they are not in the case of unstable angina. Nitroglycerin is administered immediately, and afterwards, the treatment is similar to the NSTEMI, platelet inhibitors and aspirin.

To learn more about these conditions from trained and AHE certified professionals at Advanced Healthcare Education centers, consider enrolling on ACLS classes in San Diego County, at any of our five locations.