Acute Coronary Syndrome (ACS) National Clinical Programme

Acute coronary syndromes and how they are treated

Acute Coronary Syndromes (ACS) are heart attacks (or myocardial infarction) and unstable angina.

There are two types of heart attack, distinguished by the electrocardiogram (ECG) appearance:

  • ST elevation myocardial infarction (STEMI); and
  • Non ST elevation myocardial infarction (NSTEMI).

The STEMI are the major heart attacks caused by a blockage in the arteries supplying blood to the heart muscle.

STEMIs are diagnosed using 12 lead ECG machines. They are treated urgently by either use of a clot-busting drug (thrombolysis) or by insertion of a wire into the artery to open it using a balloon to allow the blood to flow to the heart muscle again. This is known as a primary percutaneous coronary intervention (PPCI), sometimes referred to as a primary angioplasty and can only be done in a hospital equipped with an emergency catheter laboratory.

NSTEMI heart attacks and unstable angina are initially treated medically and in the majority of cases are sent for an early investigation of the arteries to the heart (called an angiography) done in a hospital equipped with a catheter laboratory.