Coronary artery disease and acute coronary syndrome are two conditions that fall under cardiovascular disease (CVD), a group of diseases that include both heart and blood vessels. Coronary heart disease (CHD) and coronary artery disease (CAD) are two main types of CVD. There are two main forms of coronary artery disease as stable ischemic heart disease and acute coronary syndrome.
The key difference between coronary artery disease and acute coronary syndrome is their symptoms. Coronary artery disease is characterized by no symptoms or mild symptoms such as stable angina or shortness of breath, while acute coronary syndrome is characterized by having serious symptoms such as unstable angina and myocardial infarction.
CONTENTS
1. Overview and Key Difference
2. What is Coronary Artery Disease
3. What is Acute Coronary Syndrome
4. Similarities – Coronary Artery Disease and Acute Coronary Syndrome
5. Coronary Artery Disease vs Acute Coronary Syndrome in Tabular Form
6. Summary – Coronary Artery Disease vs Acute Coronary Syndrome
7. FAQ – Coronary Artery Disease and Acute Coronary Syndrome
What is Coronary Artery Disease?
Coronary artery disease (CAD) is due to a narrowing or blockage of the coronary arteries that supply oxygen to the heart. There are two main forms of coronary artery disease as stable ischemic heart disease and acute coronary syndrome. Stable ischemic heart disease is a chronic form where coronary arteries gradually narrow over many years. Acute coronary syndrome is a sudden form and is a medical emergency. In acute coronary syndrome, a plaque in the coronary artery suddenly ruptures and forms a blood clot that blocks blood flow to the heart. It is estimated that over 18 million adults in the United States have coronary artery disease. This condition may present with no symptoms or some mild symptoms such as stable angina and shortness of breath (dyspnea).
Coronary artery disease is caused by atherosclerosis. The risk factors include family history, being older than 45, eating a lot of saturated fat, not exercising enough, not sleeping enough, smoking, high blood pressure, low HDL and high LDL cholesterol, anemia, autoimmune diseases, chronic kidney disease, diabetes, early menopause, endometriosis, and use of hormonal birth control.
Coronary artery disease can be diagnosed through physical examination, blood test, cardiac catheterization, CT scan, heart MRI, coronary calcium scan, echocardiogram, electrocardiogram, exercise stress test, and chest X-ray. Furthermore, coronary artery disease is treated through lifestyle changes, managing underlying conditions, medications such as blood pressure-lowering drugs, cholesterol-lowering drugs, nitroglycerin, and ranolazine, anticlotting drugs, surgeries like percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
What is Acute Coronary Syndrome?
Acute coronary syndrome (ACS) is a type of coronary artery disease that occurs suddenly and presents with unstable angina and myocardial infarction (non-ST elevation myocardial infarction and ST elevation myocardial infarction). It is a medical emergency. The signs and symptoms of this condition may include unstable angina or a heart attack (myocardial infarction), chest pain or pressure (angina), shortness of breath (dyspnea) or dizziness, sudden sweating, fatigue, palpitation, upper abdominal pain, nausea, and vomiting. An acute coronary syndrome is also caused by atherosclerosis.
The risk factors for this condition are age (people assigned male at birth who are over 45 years of age or people assigned female at birth who have completed menopause), family history, obesity, cocaine use, lack of physical activity, smoking, unhealthy diet, other conditions like COVID-19, diabetes, high blood cholesterol, high blood pressure, preeclampsia or diabetes during pregnancy.
Acute coronary syndrome can be diagnosed through physical examination, blood tests, an EKG, exercise stress test or medication stress test, CT scan, or heart MRI. Furthermore, acute coronary syndrome may include medications such as anticoagulants, angiotensin converting (ACE) inhibitors, beta-blockers, nitroglycerin, pain relievers, statins, clot-busting drugs, surgeries such as angioplasty, coronary artery bypass surgery (CABG), and percutaneous coronary intervention (PCI).
Figure 02: Acute Coronary Syndrome
Similarities Between Coronary Artery Disease and Acute Coronary Syndrome
- Coronary artery disease and acute coronary syndrome are two associated medical conditions.
- In fact, acute coronary syndrome is a type of coronary artery disease.
- Both are caused by atherosclerosis.
- They show similar symptoms and similar risk factors.
- Both can be diagnosed through physical examination and imaging tests.
- They can be treated through specific medications and surgeries.
Difference Between Coronary Artery Disease and Acute Coronary Syndrome
Definition
- Coronary artery disease is a chronic condition that presents with no symptoms or mild symptoms, such as stable angina and shortness of breath.
- Acute coronary syndrome occurs suddenly and presents with serious symptoms such as unstable angina and myocardial infarction.
Risk Factors
- Risk factors for CAD include a family history of heart disease, being assigned male at birth and older than 45 years, a diet high in saturated fat, insufficient exercise and sleep, smoking, high blood pressure, low HDL and high LDL cholesterol, anemia, autoimmune disorders, chronic kidney disease, diabetes, early menopause, endometriosis, and the use of hormonal birth control.
- Risk factors for ACS include age (being assigned male at birth and over 45 years old or having completed menopause if assigned female at birth), family history of heart disease, obesity, cocaine use, lack of physical activity, smoking, an unhealthy diet, other conditions such as COVID-19, diabetes, high blood cholesterol, high blood pressure, preeclampsia or diabetes during pregnancy.
Symptoms
- CAD may be asymptomatic or present mild symptoms such as stable angina and shortness of breath (dyspnea).
- ACS symptoms include unstable angina or myocardial infarction, chest pain or pressure (angina), shortness of breath (dyspnea), dizziness, sudden sweating, fatigue, palpitations, upper abdominal pain, nausea, and vomiting.
Diagnosis
- Diagnosing CAD involves physical examination, blood tests, cardiac catheterization, CT scans, heart MRIs, coronary calcium scans, echocardiograms, electrocardiograms, exercise stress tests, and chest X-rays.
- Diagnosing ACS involves physical examination, blood tests, electrocardiograms, exercise or medication stress tests, CT scans, or heart MRIs.
Treatment
- CAD treatment includes lifestyle changes, managing underlying conditions, medications such as blood pressure and cholesterol-lowering drugs, nitroglycerin, ranolazine, anticlotting drugs, and procedures such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
- ACS treatment includes medications such as anticoagulants, ACE inhibitors, beta-blockers, nitroglycerin, pain relievers, statins, and clot-busting drugs. Surgical options may involve angioplasty, coronary artery bypass surgery (CABG), and percutaneous coronary intervention (PCI).
The following table summarizes the difference between coronary artery disease and acute coronary syndrome.
Summary – Coronary Artery Disease vs Acute Coronary Syndrome
Coronary artery disease and acute coronary syndrome are two associated medical conditions. This is because acute coronary syndrome is a type of coronary artery disease. Both are caused by atherosclerosis. However, coronary artery disease is a chronic condition that presents with no symptoms or mild symptoms, such as stable angina and shortness of breath, while acute coronary syndrome occurs suddenly and presents with serious symptoms, such as unstable angina and myocardial infarction. This is the summary of the difference between coronary artery disease and acute coronary syndrome.
FAQ: Coronary Artery Disease and Acute Coronary Syndrome
1. What are the main symptoms of coronary artery disease?
- The main symptoms include chest pain (angina) that may feel pressure or tightness in the chest, shortness of breath, fatigue that may feel unusually tired, and heart attack (myocardial infarction).
2. What causes coronary artery disease?’
- Coronary artery disease is often caused by cholesterol (plaque), a waxy substance that builds up inside the lining of the coronary arteries. This plaque buildup can partially or totally block blood flow in the large arteries of the heart, which supply oxygen to the heart.
3. What is the most common treatment for coronary artery disease?
- Lifestyle changes, managing underlying conditions, medications such as blood pressure-lowering drugs, cholesterol-lowering drugs, nitroglycerin and ranolazine, anticlotting drugs, surgeries like percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
4. What are the cardinal signs of acute coronary syndrome?
- Chest pain or discomfort, which may involve pressure, tightness or fullness, pain or discomfort in one or both arms, the jaw, neck, back, or stomach, shortness of breath (dyspnea), dizziness or lightheadedness, nausea, and sweating.
5. How to diagnose and treat acute coronary syndrome?
- Diagnosis is usually done by electrocardiography (ECG) and biomarkers. Treatment is carried out with antiplatelets, anticoagulants, nitrates, and beta-blockers. For STEMI (ST elevation myocardial infarction), emergency reperfusion via fibrinolytic drugs, percutaneous intervention, or occasionally, coronary artery bypass graft surgery are performed.
Reference:
1. “What’s Draggin’ Your Heart Down?” Cleveland Clinic.
2. “Acute Coronary Syndrome (ACS): Causes, Symptoms & Treatment.” Cleveland Clinic.
Image Courtesy:
1. “Heart attack diagram” By Unknown author – (Public Domain) via Commons Wikimedia
2. “Depiction of a person suffering from Coronary Artery Disease” By Myupchar.com (CC BY-SA 4.0) via Commons Wikimedia
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