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Treatments and drugs
By Mayo Clinic staffTreatment for acute coronary syndrome varies, depending on your symptoms and how blocked your arteries are.
Medications
It's likely that your doctor will recommend medications that can relieve chest pain and improve flow through the heart. These could include:
- Aspirin. Aspirin decreases blood clotting, helping to keep blood flowing through narrowed heart arteries. Aspirin is one of the first things you may be given in the emergency room for suspected acute coronary syndrome. You may be asked to chew the aspirin, so it's absorbed into your bloodstream more quickly. If your doctor diagnoses your symptoms as acute coronary syndrome, he or she may recommend daily aspirin therapy.
- Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. If you're having a heart attack, the earlier you receive a thrombolytic drug after a heart attack, the greater the chance you will survive and lessen the damage to your heart.
- Nitroglycerin. This medication for treating chest pain and angina temporarily widens narrowed blood vessels, improving blood flow to and from your heart.
- Beta blockers. These drugs help relax your heart muscle, slow your heart rate and decrease your blood pressure, which decreases the demand on your heart. These medications can increase blood flow through your heart, decreasing chest pain and the potential for damage to your heart during a heart attack.
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). These drugs allow blood to flow from your heart more easily. Your doctor may prescribe ACE inhibitors or ARBs if you've had a moderate to severe heart attack that has reduced your heart's pumping capacity. These drugs also lower blood pressure and may prevent a second heart attack.
Surgery and other procedures
If medications aren't enough to restore blood flow through your heart, your doctor may recommend one of these procedures:
- Angioplasty and stenting. In this procedure, your doctor inserts a long, thin tube (catheter) into the blocked or narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls. A mesh tube (stent) is usually left in the artery to help keep the artery open. Angioplasty may also be done with laser technology.
- Coronary bypass surgery. This procedure creates an alternative route for blood to go around a blocked coronary artery. The blocked portion of the artery in your heart is removed, and an artery from another part of your body, such as your leg, replaces the removed portion.
- Acute coronary syndrome. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3010002. Accessed Feb. 7, 2008.
- Achar SA, et al. Diagnosis of acute coronary syndrome. American Family Physician. 2005;72(1):119-126.
- Acute coronary syndromes: A national clinical guideline. National Guideline Clearinghouse. http://www.guideline.gov/summary/summary.aspx?doc_id=10585. Accessed Nov. 7, 2007.
- Rackley CE, et al. The role of plaque ruptures in acute coronary syndromes. http://www.uptodate.com/home/index.html. Accessed Jan. 18, 2008.
- Ryan TJ, et al. Management of suspected acute coronary syndrome in the emergency department. http://www.uptodate.com/home/index.html. Accessed Jan. 18, 2008.
- Rosenson RS. Cholesterol lowering after an acute coronary syndrome. http://www.uptodate.com/home/index.html. Accessed Jan. 18, 2008.
