- Congested lungs:
- During examination with a stethoscope
- Excessive sweating
- Creased ear lobe
- Heart murmur
- Rapid pulse
- High blood pressure
- Low blood pressure
- Irregular heartbeat
- Leg swelling
- Foot swelling (bilateral)
- Swollen veins in the neck
Testing is necessary to confirm the diagnosis of acute coronary syndrome.
Tests that may be used to evaluate acute coronary syndrome include:
Additional tests that may be used to evaluate acute coronary syndrome include:
- Chest x-ray:
- Exercise stress test
- Cardiac catheterization
- Intracoronary ultrasound:
- Shows the structure of the arteries inside the heart
- MRI scan
- MRI scan of the heart:
- Shows detailed images of the heart and coronary arteries
- Detects structural abnormalities of the heart
- MUGA scan
- SPECT scanning of the heart:
- Detects blood flow abnormalities to heart muscle
- Thallium heart scan
- Coronary artery CT scanning:
- Checks for possible obstructions in the coronary arteries
- Can show a build-up of calcium in a coronary artery
- Rubidium PET/CT scanning of the heart:
For more information:
An electrocardiogram or ECG can be an effective tool in the evaluation of acute coronary syndrome.
How an ECG Works
An electrical impulse stimulates the muscle fibers in the heart to contract. The impulse spreads through the heart in a very organized manner. The heart's normal electrical impulse has a characteristic pattern. The EKG machine displays the pattern of the electrical impulse.
Abnormal electrical patterns on the EKG can help identify heart disease.
The EKG can identify:
ACS Heart Catheterization
Cardiac catheterization and coronary angiogram are effective tools for evaluating the patient with acute coronary syndrome.
How Heart Catheterization Works
During a cardiac catheterization, a catheter (thin plastic tube) is inserted into an artery in the groin, and then threaded up through the aorta to the heart. The catheter can be used to inject x-ray dye into the coronary arteries that supply the heart. An x-ray machine is used to take pictures of the dye inside the coronary arteries. This procedure is referred to as coronary angiography. Using these procedures doctors can detecting narrowing or obstruction of the coronary arteries.
ACS Thallium Stress Test
Thallium stress testing is an effective tool for evaluating the patient with acute coronary syndrome.
How Thallium Stress Testing Works
The thallium stress test identifies areas of the heart muscle that receive reduced blood flow from narrowed or blocked coronary arteries. During the test, thallium is injected into the bloodstream. Heart muscle cells collect the thallium in the bloodstream. If blood flow is reduced through one of the coronary arteries, then the muscle cells that are supplied by that artery do not collect as much thallium as muscle cells that receive normal blood flow. A special camera is used to detect thallium in the heart muscle and a computer constructs images of the heart. The images show areas that receive reduced blood flow.
Continue to ACS Treatment
- Achar SA, Kundu S, Norcross WA. Diagnosis of acute coronary syndrome. Am Fam Physician. 2005 Jul 1;72(1):119-26. 
- Brown TL, Merrill J, Hill P, Bengel FM. Relationship of coronary calcium and myocardial perfusion in individuals with chest pain. Assessed by integrated rubidium-82 PET-CT. Nuklearmedizin. 2008;47(6):255-260. 
- Mattu A, Petrini J, Swencki S, Chaudhari C, Brady WJ. Premature atherosclerosis and acute coronary syndrome in systemic lupus erythematosus. Am J Emerg Med. 2005 Sep;23(5):696-703. 
- Moriel M, Behar S, Tzivoni D, Hod H, Boyko V, Gottlieb S. Management and outcomes of elderly women and men with acute coronary syndromes in 2000 and 2002. Arch Intern Med. 2005 Jul 11;165(13):1521-6. 
- Ofili E. Acute coronary syndrome in women. J Fam Pract. 2005 Jul;Suppl:6-7. 
- Perers E, Caidahl K, Herlitz J, Karlson BW, Karlsson T, Hartford M. Treatment and short-term outcome in women and men with acute coronary syndromes. Int J Cardiol. 2005 Aug 18;103(2):120-7. 
- Thuresson M, Jarlov MB, Lindahl B, Svensson L, Zedigh C, Herlitz J. Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes. Am Heart J. 2005 Aug;150(2):234-42. 
- Wallentin L. Prevention of cardiovascular events after acute coronary syndrome. Semin Vasc Med. 2005 Aug;5(3):293-300. 
- Yilmaz H, Basarici I. Troponin levels and acute coronary syndrome. J Am Coll Cardiol. 2005 Aug 16;46(4):741.