Coronary Artery Disease vs. Acute Coronary Syndrome

Three forms of coronary artery disease are referred to as acute coronary syndrome. They're all related to the potentially fatal accumulation of plaque in the arteries supplying blood to the heart muscle.

Reduced blood flow to the heart muscle is referred to as coronary artery disease (CAD) or acute coronary syndrome (ACS), a condition that can lead to a heart attack.

The term "ACS" refers to a group of different forms of CAD that result from plaque accumulation in the coronary arteries.

High cholesterol and smoking are among the diseases that are risk factors for both ACS and CAD. If detected early enough, CAD and ACS can be effectively treated to prevent a heart attack or other problems.

Although there are options for emergency care after a heart attack, long-term health issues may result from the damage to the heart tissue.

What is coronary artery disease (CAD)?

The term "CAD" describes the narrowing of the arteries that carry oxygen-rich blood to your heart. It is the most prevalent type of cardiac illness.

Most people assume that CAD results from obstructive coronary artery disease, or plaque accumulation in the arteries. Atherosclerosis is the term for the accumulation of plaque, which is composed of lipids, cholesterol, and other compounds, inside the arteries.

The lumen, or opening through which blood flows, is narrowed by plaque, which also stiffens the arteries and reduces their ability to expand and contract in response to changes in your body's conditions.

When atherosclerosis impairs circulation to the extent that the heart may go without a sufficient and consistent flow of blood rich in nutrients, the condition known as obstructive CAD is identified.

A ruptured plaque can potentially result in the formation of a blood clot, which can obstruct or drastically lower blood flow in a coronary artery. Angina may strike in either scenario.

What are the symptoms of CAD?

All forms of CAD can cause the following symptoms:
  • chest pain, pressure, or tightness
  • pain in the shoulder, arm, neck, jaw or upper back
  • shortness of breath
  • fatigue
  • lightheadedness
  • nausea
  • weakness
On the other hand, a person may have plaque accumulation in one or more arteries without exhibiting any symptoms. Some people's first experience with CAD symptoms is a heart attack.

What is an acute coronary syndrome (ACS)?

Types of CAD specifically associated with plaque accumulation in the coronary arteries are included in ACS.

The severity of each kind of ACS varies, as does the location of the blockage and the duration of the reduced or stopped blood flow to the heart. Furthermore, although ACS is always symptomatic, CAD might exist without any indications. The symptoms of ACS and CAD are comparable.

The ACS covers the following three categories of CAD:

Unstable angina

Angina is the term for chest pain brought on by a decrease in blood flow to the heart muscle. Stable angina is the term for when it happens with physical exercise when the heart is pumping more blood than usual.

Unstable angina is the term for this kind of chest discomfort that can occur at any time, even while you're at rest. One form of ACS that is thought to be more deadly and a sign of a heart attack is unstable angina.

Non-ST-elevation myocardial infarction (NSTEMI)

NSTEMI is a kind of heart attack that can sometimes be identified by an ECG (electrocardiogram), but it can also be identified by a blood test. It happens when there is just partial blockage of blood flow or when the restriction is transient.

ST-elevated myocardial infarction (STEMI)

An electrocardiogram (ECG) or blood test cannot diagnose STEMI, a far more dangerous form of heart attack. Long-lasting coronary artery obstruction that seriously damages cardiac muscle tissue is its defining feature.

What causes CAD and ACS and who’s at risk?

Although there are several significant risk factors, some of which are under your control, anyone can develop CAD and ACS. Among them are:
  • diabetes
  • sedentary lifestyle
  • smoking
  • high blood pressure
  • high cholesterol levels
Since atherosclerosis can develop throughout a lifetime, getting older is also a major risk factor for obstructive CAD.

According to the Heart and Stroke Foundation of Canada, women account for around 90% of SCAD cases, and the majority of these cases occur in the 30- to 60-year-old age range.

How are CAD and ACS treated?

Relieving symptoms and restoring normal blood flow to the heart muscle are the primary objectives of treatment for ACS and CAD.

Medication used to treat ACS often consists of:
  • anticoagulants to assist break up or stop the formation of new clots, such as heparin or aspirin
  • antihypertensive drugs that decrease blood pressure, including ACE inhibitors
  • beta blockers to reduce blood pressure and lessen the heart's strain
  • To assist enlarge blood arteries, enhancing circulation, and treating angina, use nitroglycerin.
  • statins to reduce cholesterol
  • thrombolytic drugs to assist in clot dissolution in the hours following a heart attack
Procedures to treat ACS (obstructive CAD) include:
  • angioplasty, which involves opening up the lumen of a coronary artery at the location of obstruction by inserting a tiny mesh tube
  • coronary artery bypass surgery (CABG), which reroutes blood flow around a significant blockage by attaching a blood conduit from another area of the body to the heart.


Types of coronary artery disease that entail plaque accumulation in the coronary arteries are included in the term "acute coronary syndrome."

Make sure you engage with your healthcare team to learn about the symptoms of a heart attack or deteriorating heart disease, as well as to take any preventive measures you can if you have been diagnosed with a heart condition and told you are at high risk for having one.

Making all of your doctor's appointments and taking your prescriptions as directed are preventative measures. Along with maintaining a balanced diet, you should abstain from smoking, binge drinking, and experiencing too much stress.

If you abide by these heart-healthy guidelines, you may be able to live a long period with heart problems like ACS and CAD.

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