Acute Coronary Syndrome (ACS)

You’ve heard of heart attacks, but what is this ACS that your health care team keeps talking about? Conditions featuring a blockage of blood to the heart—most commonly, heart attack and unstable angina—are covered under the umbrella of acute coronary syndrome. These emergency situations require immediate treatment.

Risk Factors

Risk factors include smoking, high blood pressure, high blood cholesterol, diabetes, being overweight or obese, inactivity, family history of chest pain, heart disease, or stroke.


Any pain or discomfort in your chest may point to a problem with your heart and should be taken seriously. It can come on suddenly (as with a heart attack), be unpredictable, or get worse with rest.

ACS symptoms include:

  • Chest pain or discomfort (may be accompanied by pressure, tightness, or fullness)
  • Pain or discomfort in the arms (one or both), jaw, neck, back, or stomach
  • Shortness of breath
  • Feeling dizzy or light-headed
  • Nausea
  • Sweating


Your health care provider will take a medical history and give you a physical exam. If ACS is suspected, these further tests may be ordered:

  • A blood test to see if heart cells are dying
  • An electrocardiogram (ECG or EKG) to measure the heart’s electrical activity and heart rhythm


If tests show a blockage of blood flow to the heart, further testing may confirm a diagnosis of ACS. The artery must then be reopened using medicines or angioplasty, in which a small balloon is inflated inside the artery to open it up. A wire mesh tube called a stent may also be placed in the artery to keep it open.

Heart Failure

Heart failure is a chronic disease with many potential causes. It can take years to develop, gradually worsening if left untreated. Heart failure usually progresses for some time before it’s diagnosed.

Heart failure patients often experience weakness and fatigue. This is because aspects of the well-oiled heart machine are not firing on all cylinders.

The heart has two sides, each with two chambers. The upper chambers (the atria) receive blood, and the bottom chambers (ventricles) pump it back into the blood vessels and throughout the body. Heart failure occurs when any of the four chambers loses the ability to keep blood flowing normally. The condition often affects the left side of the heart first, although it can affect either or both sides at once. Congestive heart failure results in a large amount of fluid buildup in the lungs, feet, ankles, or legs.

Here are some common causes of heart failure:

  • Coronary artery disease – When the heart’s arteries are blocked, this slows the flow of blood to the heart muscle, sometimes causing serious damage. The healthy tissue also has to work that much harder to keep the blood flowing, which may enlarge and weaken the heart’s chambers.
  • High blood pressure (hypertension) – Uncontrolled high blood pressure—the force of blood against the artery walls—increases the risk of heart failure and stroke. High blood pressure forces your heart to pump harder to keep enough blood circulating, which can eventually expand and weaken the heart’s chambers.
  • Abnormal heart valves – When the heart’s valves don’t open or close as they should, the heart muscle has to work harder to compensate.
  • Heart muscle disease (cardiomyopathy) or inflammation (myocarditis) – Damage to the heart muscle—from drug or alcohol abuse, viral infection, a heart defect at birth, or another cause—can lead to heart failure.
  • Heart defects present at birth (congenital heart defects) – Some people are born with hearts that have defects in the chambers, valves, or arteries. In these individuals, the healthy parts of the heart must struggle to compensate, weakening the heart.
  • Severe lung disease – Conditions that restrict lung function cause the heart to work harder.
  • Diabetes – This disease strains heart function. People living with diabetes also tend to have conditions that increase their risk of heart disease, including being overweight or having high blood pressure and elevated cholesterol levels.