The European Society of Cardiology (ESC) has published a set of treatment guidelines for non-ST-segment elevation acute coronary syndromes on Saturday, August 29.

In a press release, the ESC notes that one in every five patients die after experiencing the most common type of heart attack within the year of their first incident. They noted chest pain as the most common symptom, along with pain that moves to either or both arms, and the neck or jaw. People who experience these symptoms should immediately call an ambulance. ESC also adds that complications like arrhythmias are another reason for the immediate need for medical support.

The full document containing the ESC guidelines is available in the European Heart Journal, dated August 29, and also on the ESC website. 

 

Targeting the Underlying Causes

The buildup of fatty deposits (atherosclerosis) - fats, cholesterol, and other substances - becoming surrounded by a blood clot, constricts the arteries that carry blood to the heart. In these situations, the ESC recommends administering stents, which are small tubes that keep a passageway open, and blood thinners to restore the patient's blood flow. In the first instance, the newly-published guidelines recommend imaging to see if the heart attack was caused by other factors, like a tear in an artery leading to the heart.

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In diagnosis, the guidelines note that there is no significant change in the electrocardiogram (ECG) reading, stating that this might be normal. The guidelines note, however, that it is important to measure troponin levels in the blood. Troponin refers to a protein complex commonly found in the heart muscles and helps regulate contraction.

Testing troponin levels in the blood can help detect heart injuries since these proteins increase if blood is blocked from or has decreased in the heart. Should this process be followed and yield normal results, the test should be repeated an hour after the diagnosis. Otherwise, hospital admission is strongly recommended.

Long-Term Management and Lifestyle Change

Also, if the leading cause is related to fat buildup, or atherosclerosis, the patients must be prescribed with blood thinners and therapies to reduce lipids in the blood vessels. Professor Jean-Philippine Collete, guidelines task force chairperson and cardiology professor in Paris' Sorbonne University, stressed the importance of a healthy lifestyle.

"Equally important is a healthy lifestyle including smoking cessation, exercise, and a diet emphasizing vegetables, fruits, and whole grains while limiting saturated fat and alcohol," Professor Collet noted.

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For long-term management of non-ST-segment elevation acute coronary syndrome, lifestyle management strategies are strongly recommended. In the press release, changes in behavior and lifestyle, as well as adherence to medication plans, can be best achieved by patients with help from a multidisciplinary team of specialists. From cardiologists, general practitioners, and pharmacists to nurses, dietitians, physiotherapists, and psychologists, different fields of expertise are required for a continuous and holistic recovery program.

The guidelines also note that in the event of sexual activity, there is a low risk of triggering a succeeding heart attack for most patients. These risks are further decreased with regular exercise. The ESC task force also recommends that healthcare providers should inquire about their patients' sexual activity and offer relevant advice and counsel.

Influenza vaccination was also included in the guidelines, requiring an annual vaccination, especially for patients who are 65 years of age or more.