Heart
Acute Coronary Syndrome
A medical emergency, including heart attacks, where blood supply to the heart muscle is suddenly blocked.
Acute Coronary Syndrome (ACS) covers STEMI, NSTEMI, and unstable angina — all caused by sudden loss of blood flow to the heart and requiring urgent specialist care. Time-critical intervention is essential to prevent permanent cardiac damage or death.
Book a Consultation
Acute coronary syndrome requires immediate medical attention, as a sudden blockage can quickly cause irreversible damage to the heart.
Types of ACS
- STEMI — complete coronary artery blockage requiring immediate emergency angioplasty
- NSTEMI — partial arterial occlusion with detectable heart muscle damage, requiring urgent catheterisation within 24–72 hours
- Unstable Angina — chest pain at rest or with minimal exertion signalling imminent heart attack risk
Symptoms
- Crushing chest pressure, tightness, or heaviness
- Pain radiating to the arm, jaw, neck, or back
- Breathlessness, cold sweats, and nausea
- Sudden fatigue
- Atypical presentations in women, older adults, and diabetic patients: back pain, indigestion-like discomfort, or unexplained fatigue
Causes & Risk Factors
- Atherosclerotic plaque rupture triggering acute blood clot formation
- Hypertension, hyperlipidemia, diabetes, smoking
- Obesity, physical inactivity, family history
Diagnosis
- 12-lead ECG
- Serial cardiac troponin blood tests
- Echocardiography
- Coronary angiography
Treatment Options
- Primary percutaneous coronary intervention (PCI) with stenting for STEMI
- Antiplatelet therapy and anticoagulation for NSTEMI and unstable angina
- Coronary artery bypass surgery (CABG) for complex multi-vessel disease
- Long-term medications: statins, beta-blockers, ACE inhibitors, dual antiplatelet therapy
Concerned About Acute Coronary Syndrome?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.