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The heart is made mainly of special muscle. The heart pumps blood into blood vessels (arteries) which take the blood to every part of the body.
The coronary arteries supply oxygen-rich blood to the heart If these arteries are narrowed or blocked, the heart does not get enough oxygen.

This can cause angina or a heart attack. The blockage can be sudden and complete, or it can come and go – clot, break open, then clot again. “In either case, the heart tissue is dying, even if it’s just a few cells or a whole big section of the heart,” Bolger said.

Like any other muscle, the heart muscle needs a good blood supply. The coronary arteries take blood to the heart muscle. The main coronary arteries branch off from the aorta. The aorta is the large artery which takes oxygen-rich blood from the heart chambers to the body. The main coronary arteries divide into smaller branches which take blood to all parts of the heart muscle.

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The term ‘acute coronary syndrome’ covers a range of disorders, including a heart attack (myocardial infarction) and unstable angina, that are caused by the same underlying problem.
The underlying problem is a sudden reduction of blood flow to part of the heart muscle. This is usually caused by a blood clot that forms on a patch of atheroma within a coronary artery.

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The types of problems range from unstable angina to an actual myocardial infarction. In unstable angina a blood clot causes reduced blood flow but not a total blockage.

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Therefore, the heart muscle supplied by the affected artery does not die (infarct). The location of the blockage, the length of time that blood flow is blocked and the amount of damage that occurs determine the type of ACS.