What is acute coronary syndrome?

by Karen Galarpe, abs-cbnNEWS.com

Posted at Jul 21 2011 08:33 PM | Updated as of Jul 22 2011 08:10 PM

MANILA, Philippines - Suspended Autonomous Region in Muslim Mindanao (ARMM) Governor Zaldy Ampatuan, a suspect in the Maguindanao massacre, has been granted an extended stay at the Philippine Heart Center as his doctors have diagnosed him with acute coronary syndrome.

Just what is acute coronary syndrome?

According to Dr. Anthony Leachon, cardiologist at the Manila Doctors Hospital, it refers to "a constellation of symptoms".

These include chest pain which comes on suddenly (acute in onset), maybe even at rest in a patient at high risk to develop heart disease.

At the emergency room, the patient has to undergo an electrocardiogram (ECG), said Leachon, "to rule out myocardial infarction, which in layman's term, is heart attack."

Aside from that, the patient will have to have his blood checked for cardiac markers, he told "Top Story" on ANC on Thursday.

Leachon said the clinical abstract on Ampatuan's condition showed that "the complete diagnosis is acute coronary syndrome, unstable angina, hypertensive cardiovascular disease."

Unstable angina, explained Leachon, is a warning sign before a heart attack.

"It's a warning sign but still an indication considering the risk factors of the patient (with hypertension, diabetes, stress, and anxiety)," he said.

The cardiologist, said Leachon, will have to admit such a patient either in an intensive care unit or coronary care unit so he can be observed further.

"We need serial ECGs and then perhaps every 6 hours, you have to draw blood," he said.

Leachon is confident in the diagnosis of Ampatuan made by his cardiologist, Dr. Danny Kuizon, at the Philippine Heart Center.

"He's a friend, esteemed colleague, a distinguished one, one of the first interventional cardiologists in the country. Ibig sabihin, may K... Dr. Cuizon is a very reputable and skilled cardiologist. In fact ang kanyang specialty is this one, he does angiogram and angioplasty, very senior cardiologist," said Leachon.

He added that doctors should treat patients regardless of their status.

"Fugitive or not, friend or foe, the doctor should actually entertain for the benefit of the doubt. Kasi paano kung totoo (na may sakit siya)? Nagkataon lang na isa siyang fugitive o perhaps an accused," Leachon said.

He explained that the patient with acute coronary syndrome should be subjected to a gamut of tests, such as an angiogram.

The angiogram, however, should not be done when a patient shows high blood pressure, as in the case of Ampatuan.

"Sabi ng cardiologist tumataas ang blood pressure (niya) yesterday. To me that is a contraindication to proceed to do an angiogram kasi mataas ang blood pressure. Siguro (wait) a day or two," he said.

A coronary angiogram will show if there are blockages in the blood vessels.

According to Kuizon, if only 1 or 2 vessels show blockages, "tapos proxima lang, ibig sabihin malapit lang, you can dilate them and put a stent." This will require a patient to stay perhaps for 2-3 days in the hospital.

But if findings show that there is severe heart disease, and if the patient is diabetic (as in Ampatuan's case), this may require a heart bypass, which will entail a longer hospital stay, he said.