Unmasking the Silent Killer: Acute Coronary Syndrome

By Alpro Pharmacy

October 4, 2023

Not all heroes wear capes. Well, our heart is one of the silent heroes that never rest nor take a break from keeping us alive, and yet, was never appreciated or taken care of. Our ignorance of our health, diet and lifestyle has caused us to repeatedly damage our heart and leading us into the trap of the silent killer: Acute Coronary Syndrome (ACS).

What is Acute Coronary Syndrome (ACS)?

ACS are a range of conditions where the blood flow towards the heart is suddenly reduced due to blockages, and they are commonly known as heart attack or angina. Blockages or plaques originate from many possible sources, including cholesterol, fat, calcium, and cellular wastes and among them, cholesterol and fat are the main culprits. 1,2

As the plaque builds up, the artery will be narrower and thus reducing the blood flow towards the heart, this causes angina (chest pain). In certain situations, the plaque will break off and follow the blood flow, it becomes a ticking bomb which will cause a heart attack whenever it obstructs any of the coronary artery completely. 1

How to know if you are experiencing a heart attack? Any signs or symptoms to look out for?

Sign and symptoms of heart attack or angina episodes: 1

  • Chest pain or discomfort (aching, pressure, tightness or burning)
  • Radiating pain originates from chest to shoulders, arms, upper belly area, back, neck or jaw
  • Nausea or vomiting, Indigestion
  • Shortness of breath
  • Sudden, heavy sweating, racing heartbeat
  • Feeling lightheaded or dizzy, fainting

Photo retrieved from4:

Vessel Blockage VS Vessel Bursting

While ACS mainly involves blockage of vessels, stroke on the other hand can be caused by both blockage and Hemorrhage (Bleeding). That is exactly why we must maintain a balanced approach to prevent both ACS and Stroke.

What you need to do

Several actions/ activities that you are advised to do to reduce the risk of ACS and Stroke, including:

  • Maintain an active lifestyle with at least 150 minutes per week of moderate-intensity exercise (e.g., jogging)2,3
  • Maintain a healthy and balance diet mainly comprises of 3
    • Vegetables and fruits.
    • Lean meat and fish.
    • Healthy fats (olive oil and avocado) or low-fat foods.
  • Manage stress and get quality sleep (> 7 hours/ day) 3
  • DO NOT smoke and LIMIT alcohol intake3

When you are regularly carrying out the above steps, congratulations!! You are significantly reducing your risk of developing ACS or Stroke!!

If you are on blood thinners for ACS or ischemic-related conditions:

  • Always follow up with the doctor with your condition regularly.
  • Always remind your doctor, pharmacist, dentist, or nurse about your medications before any procedure.
  • Always look out for bleeding symptoms:
    • Bleeding while brushing teeth
    • Unexplained bruises
    • Dark, tarry stools
  • Always maintain a regular portion of leafy vegetables for those who are taking warfarin.


Poor medication adherence will increase the risk of mortality by 21%!!! So, do you see the importance of adhering to your regime?

Here is how it helps you:

  • Preventing Recurrent Events: Adhering to prescribed medications, such as blood thinners reduces the risk of recurrent cardiac events. These medications help prevent further blood clot formation, manage blood pressure, and lower cholesterol levels, all of which are essential for reducing the risk of subsequent heart attacks or ischemic events.
  • Stabilizing Plaques: Medications like statins not only lower cholesterol but also have a stabilizing effect on atherosclerotic plaques in the coronary arteries. This reduces the likelihood of plaque rupture, which can lead to acute blockages and heart attacks.
  • Improving Blood Flow: Antiplatelet drugs, in particular, help prevent the formation of blood clots that can partially or completely block blood flow in coronary arteries. This is crucial for preserving heart muscle function and minimizing damage during ACS.

Important takeaways

Always consult and follow up with your doctor or pharmacist about any doubts, side effects or any worsening of your symptoms. Seek medical help immediately by calling 999 in case of any worsening of angina or signs of heart attack, IT IS A LIFE-THREATENING MEDICAL EMERGENCY. Lastly, remember to always ADHERE TO YOUR MEDICATION REGIME! 1,2

This article is supported by #Sanofi


  1. Mayo Clinic. (2019). Acute Coronary Syndrome. Retrieved September 25, 2023, from Mayo Clinic website: 
  2. Parker, H. (2023). Clogged Arteries (Arterial Plaque). Retrieved September 25, 2023, from WebMD website: 
  3. Mayo Clinic. (2023). Strategies to prevent heart disease. Retrieved September 25, 2023, from Mayo Clinic website: 
  4. Cleveland Clinic. (2022). Angina (Chest Pain). Retrieved September 25, 2023, from Cleveland Clinic website: 
  5. Walsh, C. A., Cahir, C., Tecklenborg, S., Byrne, C., Culbertson, M. A., & Bennett, K. E. (2019). The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐ British Journal of Clinical Pharmacology, 85(11). 
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