ACS: Its Association with Endothelial Dysfunction and Elevated Basal Sympathetic Activity

The exact pathophysiol[ogy of Acute Coronary Syndrome (ACS) remains elusive.Healthy endothelium provides normal flow in the coronary circulation.Endothelial dysfunction has a close association with atherosclerosis and ACS.The less commonly noticed finding is the association of high basal sympathetic discharge in ACS.The role of high basal sympathetic discharge in ACS therefore needs to be reviewed.Functions of the healthy endothelium, endothelial dysfunction, atherosclerosis risk factors, basal sympathetic discharge/Sympathetic Skin Response (SSR), and central connections are reviewed.Basal sympathetic discharge was very high in cases of ACS (spike response in SSR).Basal sympathetic discharge arises from the hypothalamus.Reduction in basal sympathetic discharge by managing lifestyle factors i.e. stress, and adequate sleep may help in the prevention of ACS.