Acute Coronary Syndrome

ACS Explained
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Acute coronary syndrome (ACS) is a medical term for chest pain or other symptoms brought on by suddenly reduced blood flow to the heart. The symptoms of ACS generally mean a person is either:

  • Having a heart attack, also known as a myocardial infarction

  • In danger of having a heart attack soon, also known as having unstable angina

ACS is considered a medical emergency and is usually evaluated in the emergency department.

If you think you or a loved one may be having ACS, call 911.

Symptoms of ACS

The symptoms of ACS are the symptoms of having a heart attack, or of unstable angina:

  • New chest pain or chest discomfort: Different people experience heart pain differently. The pain may feel like pressing, crushing, burning, squeezing, an ache, or a knot in the chest. The pain may spread to the throat, jaw, or left arm.

  • Shortness of breath: The person may have difficulty catching her breath or may be panting.

  • Sweating or clamminess: The person may be sweating a lot or may feel cold and clammy.

  • Nausea and/or vomiting: The person may feel nauseous or may throw up.

  • New, unexplained weakness, fatigue, or delirium: Frail older adults, especially those with dementia, may have only vague symptoms when in the midst of ACS.

These are the more common and classic symptoms of ACS, but some people, especially women and older adults, may experience more atypical symptoms or may not have any chest pain at all.

For those people who have already been diagnosed with angina, unstable angina means symptoms that don't go away as usual with rest or nitroglycerin, or symptoms that are much worse than usual.

Dr. Leslie Kernisan

Leslie Kernisan is a clinical instructor in the University of California, San Francisco, Division of Geriatrics, and maintains a popular blog and podcast at BetterHealthWhileAging. See full bio