Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be going through acute coronary syndrome.

And you can find written notes on this topic at zero to finals.com slash ACS

or in the cardiology section of the Zero Definals Medicine Book.

So let's get straight into it.

Acute coronary syndrome is usually the result of a thrombus from an atherosclerotic plaque

blocking a coronary artery. When a thrombus forms in a fast-flowing artery,

such as the coronary arteries, it's formed mainly of platelets. This is why anti-platelet medications

such as aspirin, clopidigril, and ticagrelor are the mainstay of treatment. There are three types of acute

coronary syndrome, and we're going to go into more detail about each of these later on. These types are

unstable angina, ST elevation myocardial infarction, or a stemmy, and non-ST elevation myocardial infarction or a stemmy and non-STE elevation myocardial infarction or an N-stemi.

Let's start with some coronary artery anatomy.

Two coronary arteries branch from the root of the aorta, the right coronary artery and the left coronary artery.

The right coronary artery curves around the side of the heart and under the heart, and it supplies

the right atrium, right ventricle, the inferior aspect of the left ventricle and the posterior septal area.

The left coronary artery becomes the circumflex artery and the left anterior descending.

The circumflex artery curves around the top of the heart, the left side and the back,

and it supplies the left atrium and the posterior aspect of the left ventricle.

The left anterior descending artery travels down the middle of the heart,

and it supplies the anterior aspect of the left ventricle

and the anterior aspect of the septum of the heart.

Let's talk about the presentation. Acute coronary syndrome typically presents with central constricting chest

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