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Disease

Acute Coronary Syndrome (ACS)

Acute Coronary Syndrome (ACS) medical illustration
Updated August 2026

Disease overview

Acute Coronary Syndrome (ACS) is a clinical syndrome caused by sudden reduction of blood flow to the heart due to plaque rupture and thrombus formation.

It includes:

  • ST-Elevation Myocardial Infarction (STEMI)
  • Non-ST-Elevation Myocardial Infarction (NSTEMI)
  • Unstable Angina

Pathophysiology

ACS commonly begins with atherosclerotic plaque disruption, platelet activation and thrombus formation that can obstruct coronary blood flow and cause myocardial ischemia or infarction.

Disease pathway

Atherosclerotic plaque rupture
Platelet activation
Thrombus formation
Coronary artery obstruction
Myocardial ischemia
Myocardial infarction

Common symptoms

Chest pain or discomfort
Shortness of breath
Sweating
Nausea or vomiting
Left arm, back, or shoulder pain
Jaw or neck discomfort
Fatigue
Dizziness

Risk factors

Hypertension
Smoking
Diabetes mellitus
Dyslipidaemia
Obesity
Sedentary lifestyle
Family history
Increasing age

Assessment

Diagnosis is made by healthcare professionals using symptoms, ECG findings, cardiac biomarkers, imaging and risk stratification where appropriate.

Assessment pathway

ECG (12-lead ECG)
Cardiac biomarkers
Coronary angiography
Echocardiography
Risk stratification

Management

Treatment strategy should follow current locally approved guidance and clinical judgement. The example flow below is for disease-education mockup content only.

Management approach

Antiplatelet therapy
Anticoagulant therapy
Statin therapy
Revascularisation (PCI)
Secondary prevention

References

  1. Ibanez B, et al. 2025 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2025.
  2. Amsterdam EA, et al. 2021 AHA/ACC Guideline for the Evaluation and Diagnosis of Chest Pain. Circulation. 2021.
  3. Collet JP, et al. 2021 ESC Guidelines on acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021.
  4. Thygesen K, et al. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018.
  5. WHO. Cardiovascular Diseases (CVDs) Fact Sheet. 2023.

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