In this article, we will discuss the Clinical Manifestations and Diagnosis of Acute Coronary Syndrome. So, let’s get started.
The diagnosis of non-ST-elevation ACS (unstable angina) is based on clinical presentation. It is diagnosed when chest discomfort is severe and has at least one of the three following features:
1. Pain/discomfort occurs at rest or with minimal exertion lasting >10 minutes
2. It is of recent onset (<2 weeks)
3. It has crescendo pattern, i.e. it is more severe, prolonged and more frequent than previous episodes.
The diagnosis is confirmed by elevated levels of biomarkers of myocardial necrosis (CPK-MB and troponins)
There is usually no physical sign but patients with rest pain frequently develop third or fourth heart sound during the episodes, and in some instances exhibit transient left ventricular failure (murmur of mitral incompetence) due to development of heart failure. Patients with ACS (Acute Coronary Syndrome) should be explored for the precipitating cause such as uncontrolled hypertension, anemia, occult thyrotoxicosis and presence of atherosclerosis (carotid, aortic or peripheral artery disease).