Acute myocardial ischemia is chest pain illness. It is happen due to insufficient blood supply to the heart muscle that results from coronary artery disease. Each year in the United States, an estimated 2 million hospitalizations are related to ACS. Coronary heart disease is the leading cause of death in the United States. Unstable angina and non-ST-segment elevation myocardial infarction are very common manifestations of this disease.



Causes

These life-threatening disorders are a major cause of emergency medical care and hospitalization in the United States. Other causes include arterial inflammation and secondary unstable angina. Arterial inflammation may be caused by or related to infection. Other causes of reduced myocardial blood flow include mechanical obstruction (e.g. air embolus), dynamic obstruction (e.g. vessel spasm), and inflammation or infection. An aberrant left main coronary artery with its origin at the right sinus of Valsalva may cause ACS, especially with exertion. Spontaneous and cocaine-related coronary artery dissection remains an unusual cause of ACS and should be included in the differential diagnosis, especially when a younger female or cocaine user is being evaluated.

Symptoms

* Chest pain or discomfort, including squeezing, crushing, pressure, tightness or heaviness in the chest.

* Pain or discomfort in your arms, shoulders, neck, back or jaw.

* Indigestion, such as heartburn and upset stomach.

* Nausea (feel sick to your stomach) and vomiting (throwing up).

* Pain in your abdomen (stomach).

* Shortness of breath.

* Sweating, weakness or fainting (passing out).

Treatment

Antithrombotic is the good treatment of acute coronary syndrome consists of aspirin and heparin. The anticoagulant used most in acute coronary syndrome is heparin. Heparin exerts its antithrombotic effect through its stimulating effect of antithrombin-III. Therefore, it is an indirect thrombin inhibitor. Hirudin is a direct thrombin inhibitor and does not need antithrombin III for its effects.

Whether a person is at moderate to high risk of a major heart attack can be judged from their symptoms and by one or both of the following test results.

* New ECG changes that show that the person's heart is not receiving enough blood.

* Blood tests that show that there has been some damage to the heart tissue.