Acute Coronary Syndrome Care
Acute coronary syndrome covers unstable angina and heart attack, where a coronary artery has suddenly narrowed or blocked. It is an emergency measured in minutes. Assessment starts at the door with an ECG and blood tests, and if an artery needs opening, the cath lab is in this building.
- ECG within minutes of arrival
- Cardiac markers tested on site
- Cath lab staffed around the clock
- No transfer for emergency angioplasty
Stay
3 to 5 days
Duration
Treatment begins within minutes of arrival
Anaesthesia
Local, if an angiogram is needed
About Acute Coronary Syndrome Care
The chest pain of acute coronary syndrome is usually a weight or a tightness rather than a sharp pain, and it may spread to the arm, jaw or back. What separates unstable angina from a heart attack is whether heart muscle has been damaged, which the ECG and blood tests answer within the first hour. Treatment starts before the answer arrives, because the drugs that help most work best early.
- Unstable angina and heart attack are treated as the same emergency at first
- Blood tests show whether heart muscle has been damaged
- Treatment starts before the diagnosis is confirmed
- Time is the single biggest factor in the outcome
Before you read on
Everything here is general information about acute coronary syndrome care. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest acute coronary syndrome care.
- Chest pain or pressure lasting more than a few minutes
- Chest discomfort with sweating, nausea or breathlessness
- Pain spreading to the arm, jaw, neck or upper back
- Sudden severe breathlessness in someone with cardiac risk factors
- Collapse with chest discomfort beforehand
Procedure details
The usual sequence, from first consultation through to follow-up.
Immediate assessment
An ECG is recorded within minutes of arrival, monitoring is attached and blood is taken for cardiac markers.
First treatment
Aspirin, other blood thinners, oxygen if needed and pain relief are given straight away, before the diagnosis is confirmed.
Deciding on the cath lab
If the ECG shows a completely blocked artery, you go straight to the cath lab for emergency angioplasty. Otherwise an angiogram is planned within the next day or two.
Coronary care and planning
You are admitted to coronary care for monitoring, medication is started, and a plan for medication, stenting or bypass is made before discharge.
How to prepare
What to sort out before you come in.
- This is an emergency and there is nothing to prepare
- Call 108 rather than driving yourself
- Chew an aspirin if you have one to hand and are not allergic
- Bring your medication list or boxes if somebody can fetch them
Recovery
What to expect afterwards, and roughly when.
- Expect three to five days in hospital depending on the treatment
- Cardiac medication is started and must be continued after discharge
- A programme of gradual activity is set out before you go home
- Smoking, blood pressure, cholesterol and sugar are addressed as part of treatment
- Follow-up in clinic is arranged before discharge
Why choose Humayun in a cardiac emergency
In a heart attack the number that matters is the time between arriving and the artery being opened.
- ECG and cardiac markers at the bedside rather than sent away
- A cath lab on site and on call, so primary angioplasty happens here rather than after a transfer
- Coronary care beds on the same floor as the lab
- Cardiologists called simultaneously with the emergency team rather than after it
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