Stephen J. Schueler, M.D.

Acute Coronary Syndrome Treatment

Acute coronary syndrome requires emergency treatment in a hospital. The type of treatment depends on many factors, including how long the pain has been present, ECG findings, x-ray results, and blood tests. Mild cases of acute coronary syndrome may respond to treatment with oxygen or nitroglycerin. Acute coronary syndrome can result in a heart attack. In severe cases, a person may be treated with thrombolytic medications, angioplasty, or coronary artery bypass surgery.

Initial treatment of acute coronary syndrome in the emergency department includes:

Key treatment of acute coronary syndrome includes:

For more information:

Acute Coronary Syndrome Angioplasty

Angioplasty is an effective treatment for acute coronary syndrome. Angioplasty is a procedure that must be performed during cardiac catheterization.

Angioplasty is more likely to be performed in the following situations:

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. During angioplasty, the catheter is advanced into the narrowed part of the coronary artery. A balloon at the end of the catheter is inflated, in order to force open the narrowed artery. Alternative techniques include cutting or burning away the blockage with a tiny blade or laser.


After angioplasty, a stent may be used to help hold the artery open. Stents are tiny struts that expand against the inside wall of the artery. They prop open the blood vessel after it has been opened.

  • Coronary artery stent
  • Coronary artery stenting

Rare complications of angioplasty include:
  • Allergic reaction to the dye
  • Heart attack
  • Coronary artery rupture
  • A small number of opened arteries become narrowed again. However, stents are used to protect against this complication.

Acute Coronary Syndrome Cardiac Rehabilitation

Those who suffer a heart attack or undergo bypass surgery lose physical strength because the heart is weakened and their activity has been limited. Cardiac rehabilitation helps the heart to recover. It provides a supervised exercise program that can restore exercise capacity and endurance.

Cardiac rehabilitation programs:

Acute Coronary Syndrome Drugs

Medications that improve blood flow through the coronary arteries include:

  • Aspirin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Heparin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Nitrates:
    • Open coronary arteries and let the heart work more efficiently
  • Platelet inhibitors:
    • Thin the blood, in order to lower the risk of blood clots in the coronary arteries
  • Thrombolytic medications:
    • Clot busting medication
  • Morphine:
    • Reduces anxiety and increased blood flow through coronary arteries

Additional medications that benefit the heart:

For more information:

Acute Coronary Syndrome General Measures

General, long term treatment for coronary artery disease includes:

Acute Coronary Syndrome Long-Term Care

The long term care of coronary syndrome depends on severity. Acute coronary syndrome describes a group of conditions that result from diseased coronary arteries.

Conditions include:

Angina SeverityTreatment Options
Stable / mild or moderateControl of cardiac risk factors; drug therapy
Unstable / mild to moderateHospitalization; control of cardiac risk factors; drug therapy
Unstable / severe symptomsDrug treatment; angioplasty; coronary artery bypass grafting

The long-term treatment of coronary artery disease and angina may include:

Acute Coronary Syndrome Questions For Doctor

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Acute Coronary Syndrome Specialist

Physicians from the following specialties evaluate and treat acute coronary syndrome:

Acute Coronary Syndrome Surgery

Blocked coronary arteries require bypass surgery. The aim is to provide blood flow to the artery beyond the blockage, bypassing the obstruction. Small arteries in the chest wall, or veins from the legs, are removed for this purpose. A small segment of the bypass vessel is attached to the wall of the diseased vessel, where blood flow is strong. And then, the other end of the bypass vessel is attached to the blocked vessel, beyond the blockage. This allows blood to flow around the blockage, restoring the delivery of oxygen and nutrients to the part of the heart that was supplied by the vessel before it became blocked.


  • Heart bypass surgery

The risks for bypass surgery:

Acute Coronary Syndrome Thrombolytics

Coronary arteries become narrowed when cholesterol builds up on the inside wall of the artery. If a clot forms where the artery is narrowed, then the artery becomes completely blocked, causing angina or a heart attack. Thrombolytic medications are powerful blood thinners that can break down new blood clots in the coronary arteries.


Thrombolytic medications include:

Severe bleeding is the major complication of the thrombolytic medications. Overall, they reduce the risk of death from a heart attack.

Conditions in which thrombolytics are not used include:

Continue to Acute Coronary Syndrome Home Care

Last Updated: Jun 3, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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