Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode I'm going to be talking to you about acute coronary syndrome.

And you can follow along with written notes on this topic at zero definals.com slash aces

or in the cardiology section of the Zero to Finals Medicine Book.

So let's get straight into it.

Let's start with pathophysiology.

Acute coronary syndrome is usually the result of a thrombus

from an atherosclerotic plaque that is blocking a coronary artery.

When a thrombus forms in a fast-flowing artery, it's made up mostly of platelets,

and this is why anti-platelet medication such as aspirin,

clopidigril and ticagrelor are the main state of treatment.

Let's go through some basic anatomy of the coronary arteries.

The left coronary artery becomes the circumflex and the left anterior descending arteries. The right coronary artery curves around the right side and

under the heart and it supplies the right atrium, the right ventricle, the inferior aspect of the left

ventricle and the posterior septal area.

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

atrium and the posterior aspect of the left ventricle.

And the left anterior descending artery travels down the middle of the heart and supplies the anterior

aspect of the left ventricle and the anterior aspect of the septum. There are three types of acute

coronary syndrome, unstable angina, ST elevation myocard lymphaction or stemmy, and non-STE elevation myocard lymphaction or N-stemi.

So how do we make a diagnosis?

When a patient presents with possible acute coronary syndrome symptoms, for example chest pain, perform an ECG initially,

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