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Acute Coronary Syndrome: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Acute coronary syndrome abbreviated as ACS is a set of condition that occurs due to the sudden reduced blood flow to the heart. It happens by the buildup of fatty deposits inside and on the wall of the coronary arteries. It leads to severe health hazards such as angina, heart attacks, stroke and other major cardiovascular diseases.

Acute coronary disorder develops over a long period of time and are more common among people over 40 years. However, it can develop in any age group due to high blood pressure or cholesterol, obesity, diabetes, family history and lack of physical activity. Some of the most common symptoms are dizziness, chest pain, nausea, excessive sweating, indigestion and shortness of breath.

The treatment for ACS starts with the first aid that is to relive pain and improve the blood flow to restore the normal functioning of the heart. Asprin is the most common drug used for this purpose. After that you would be treated either on medication or surgery depending on the problem. Some of the most common prescribed drugs for ACS are Nitroglycerin, Beta blockers, Angiotensin- converting enzyme (ACE) inhibitors, Antiogensin receptors blockers (ARBs) , Antiplatelet drugs and Statins. If medication is ineffective in treating the problem and restore proper blood functioning, then you would be prescribed angioplasty, stenting and in some very severe cases surgeries as well.

How is the treatment done?

The treatment of acute coronary disease depends totally on the type of coronary artery disease. Acute coronary disease is classified into two major categories namely unstable angina and heart attack which is further divided into Non ST segment elevation myrocardial infraction and ST segment myrocardial infraction. The first mode of treatment is medication that includes drugs and artificial supporters. Thrombolytics helps in dissolving blood clot in the blood vessel, Nitroglycerin improves blood circulation and antiplatelet drugs such as Asprin and Plavix prevents blood clot formation. Beta blockers are used to slow down your heart rate and statins lower the amount of cholesterol in the blood.

Artificial supporters such as Angiotensin receptor blockers helps in controlling blood pressure and Angiotensin – converting enzyme (ACE) inhibitors expand blood vessels and improve blood circulation. Surgeries are always the last option in case of severe conditions. Minor surgeries includes Angioplasty and Stenting . In this process, a long or tiny tube (catheter) is inserted into the blocked artery and then a wire with a deflated balloon is passed through the catheter. The balloon is then inflated which opens up the blocked artery by compressing the plaque against your artery. Stenting is done by inserting a mesh tube (stent) in the artery to keep it open. Bypass surgery is the last and final option in which an artificial route is created by taking a piece of blood vessel (graft) from another part of your body. The blood goes around or bypasses the blocked coronary artery reaching the heart.

Who is eligible for the treatment? (When is the treatment done?)

It is most common among men and women after the age of 40 years, however it can happen to younger person as well considering the modern life style and their diet. There are many symptoms that can help you diagnose the problem at early stages. Chest pain and pain in shoulder, arms, back and neck are the most common one. People who are obese should also go for regular checkups as they are more prone to ACS.

Who is not eligible for the treatment?

There is no such thing as non eligibility as acute coronary disease can happen to anybody. Even if you have worked on all the aspect that is maintaining a healthy lifestyle or keeping yourself stress free, family history could also make you prone to this condition. So the treatment is a must as the results are fatal. Only nitrates are strictly forbidden for patients who are hypotensive that is systolic BP <90 mm Hg.

Are there any side effects?

The side effects of angioplasty may include kidney problems, stroke, coronary artery disease, abnormal heart rhythms and even heart attack. The side-effects associated with stenting are blood clots, heart attack, blockage of artery, breathing problems due to anesthesia or inserting the stent in the bronchi, allergic reactions due to dyes and medications used in the procedure and even kidney stones due to using a stent in the ureters. A person can experience side-effects after undergoing coronary bypass surgery. The symptoms include itching or discomfort from healing incisions, swelling of the area where an artery or vein was removed for grafting, fatigue, mood swings and depression, loss of appetite and problems in sleeping, constipation and chest pain around the site of the chest bone incision.

What are the post-treatment guidelines?

Since the diseases is related to blocked arteries, blood flow and cardiovascular health, the post treatment guidelines includes everything that has a direct relation to your cardiovascular health. Complete and proper rest is a must for at least 4 to 6 weeks. Dietary restrictions are prescribed to be followed strictly which includes lots of water, green vegetables and fruits. You have to avoid fats and fat rich products such as meat, eggs, oily foods and street foods. After the initial period, walking and some light exercises are to be followed on a daily basis.

How long does it take to recover?

it totally depends on the condition and the treatment that followed. If you have not gone under the knife and the problem was cured by medication then the recovery period may vary up to 2 to 6 weeks. However, if an angioplasty or bypass surgery is done then the recovery period is very high. Even for a minor surgery the recovery period is at least 4 weeks. In cases of major surgeries, the recovery could take up to 4 to 6 months and even longer in some extreme cases.

What is the price of the treatment in India?

the price of the treatment varies greatly depending on the problem you have and the mode of treatment. Medication for acute coronary syndrome could start at INR 1000 per month and can go up to INR 5000. Other treatment such angioplasty and bypass surgeries are very expensive. It could range between INR 1 lakh to up to INR 10 lakhs which will cover all your expenses including the hospital charge, medication and operation cost. Again this price may fluctuate depending on your city and the hospital as well.

Are the results of the treatment permanent?

The success rate for bypass surgeries are quite high. It drops down only in very extreme cases. Whatever the mode of treatment was, the results are more or less permanent depending on how you would follow the post treatment guidelines. So as for the initial phase, the results are mostly permanent but you can develop acute coronary syndrome time and again because of living and food habits and also negligence.

What are the alternatives to the treatment?

The best alternative and the best way to prevent acute coronary syndrome is a healthy lifestyle. Keeping yourself fit and healthy improve your hearts health. Proper sleep and rest along with healthy eating habits can reduce the chances of acute coronary syndrome by huge margin. Some of the most effective foods that improve heart health are garlic, onion, fish oil, olive oil, and nuts. Ayurvedic and homeopathic medicines are also very effective in the initial stages. Other alternatives for treating ACS include yoga and meditation.

Popular Questions & Answers

Differential diagnosis plays an important role in patients suffering from an acute coronary disease.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
In a doubtful case of ACD the person need to tested in detail for blood vessel block , cardiac damage and anginal attacks and proper medication need to be taken

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