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JAMA Patient Page |

Acute Coronary Syndrome FREE

Alexander C. Fanaroff, MD; Jennifer A. Rymer, MD, MBA; Sarah A. Goldstein, MD
JAMA. 2015;314(18):1990. doi:10.1001/jama.2015.12743.
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Published online

Acute coronary syndrome (ACS) refers to a group of conditions characterized by poor blood flow to heart muscle.

ACS includes both unstable angina (increasing chest pain, or chest pain at rest) and myocardial infarction (heart attack). Most cases are caused by a blocked blood vessel in the heart. Because of the blockage, the heart muscle does not get enough blood or oxygen. A Rational Clinical Examination in the November 10, 2015, issue of JAMA provides more information on ACS. Patients who already have blocked blood vessels in the heart have especially high risk for ACS. Other risk factors include

  • High blood pressure

  • High cholesterol

  • Cigarette smoking

  • Diabetes

  • Increasing age


  • Pressure-like chest pain

  • Pain in the shoulders (one or both), jaw, or back

  • Shortness of breath

  • Cool, clammy skin

  • Nausea

  • Lightheadedness

Other conditions can cause these symptoms. But if you do have ACS, you will need emergency treatment. The time between start of symptoms and treatment should be as short as possible. If you have chest pain, especially if you have 1 or more of the above risk factors, call 911 (in the United States).

At the hospital, doctors will examine you and take your medical history. They will also check your heart rhythm and do a blood test. This test can show if your heart muscle has been injured.

Based on the results, you might be sent home and asked to see your usual doctor. Or you might be admitted to the hospital for treatment.


Treatments include medicines to lower your blood pressure, lower your cholesterol, and keep your blood from clotting. These medicines will be started in the hospital, but you will still need to take them after you go home. You may also need to have cardiac catheterization. In this procedure, the doctor injects dye into blood vessels in the heart. This helps show where the vessels are blocked. You might also receive a coronary stent at this time. The stent helps keep blocked blood vessels open. However, you might need to have open heart surgery instead.


  • Eat a healthful diet

  • Exercise regularly

  • Quit smoking (or don’t start)

  • Control your blood pressure and cholesterol

  • Control your blood sugar if you have diabetes

  • Ask your doctor about taking a low-dose aspirin every day

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To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab.


The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: American Heart Association, American College of Cardiology.

Topic: Cardiology



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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Spanish Patient Page: Síndrome coronario agudo

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