Acute Coronary Syndrome (ACS)

Hyperbaric Oxygen Therapy Approval Status

No Clearance by US Food and Drug Administration (FDA)

No Approval by the Undersea and Hyperbaric Medical Society (UHMS)

About Clearance and Approval


Definition and Causes

Acute coronary syndrome (ACS) is a blockage of the small blood vessels that supply the heart muscle with oxygen. ACS includes heart attack, called myocardial infarction, and chest pain or discomfort, called angina. People who experience heart attacks require immediate treatment by emergency medical personnel. Heart attacks often lead to sudden cardiac arrest or cardiac death.

ACS is caused by coronary artery disease (CAD), also called coronary heart disease (CHD). The most common type of heart disease, CAD is a narrowing of the small blood vessels that supply the heart with oxygen. The narrowed vessels may become clogged with blood clots or fat deposits circulating with the blood. Heart disease is the leading cause of death for both men and women in the US.

Evidence Index

FDA cleared, widely reimbursed
Strong body of evidence
Repeatedly favorable results
Early or mixed results
Unfavorable or no evidence
Strong evidence against HBOT

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) may reduce the risk of dying, the time to pain relief, and the chance of future heart attacks in people with acute coronary syndrome. HBOT is thought to increase the supply of oxygen to the heart and may decrease the area of damage and death in the heart muscle. More research is needed to confirm the efficacy of HBOT in conjunction with standard regimens and to identify the types of patients who may benefit.

HyperbaricLink Commentary

In 2004, and then in September 2014, the Cochrane Heart Group reviewed 6 randomized controlled trials with 665 participants. The review authors conclude there is some evidence HBOT may reduce the risk of death, amount of heart damage, and duration of pain for patients experiencing heart attack and severe angina. At the same time, they note limitations in the studies they evaluated and conclude more substantial research is required before the benefits of HBOT for ACS patients are proven. Lacking that evidence, HBOT cannot be recommended for routine treatment of heart attack or severe angina according to the authors. [ Cochrane, 2015 ]

As of mid-2015 there are no registered studies investigating the treatment of acute coronary syndrome with hyperbaric oxygen therapy. [ ] Without a large, well-controlled study underway the body of evidence for this use of hyperbaric oxygen will remain at promising, at best.

Patient Resources

HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community support for acute coronary syndrome (ACS) and heart disease.

American Heart Association

With a mission to build healthier lives, free of cardiovascular diseases and stroke, the American Heart Association offers loads of information about ACS and heart disease, with especially fine patient resources through its HeartHub web portal.

Does hyperbaric oxygen therapy improve outcome after heart attack?

Cochrane is a “global independent network of researchers, professionals, patients, carers, and people interested in health” with a mission to improve healthcare decisions by providing high-quality synthisized research evidence. The Cochrane Heart Group has reviewed studies of heart attact and severe angina patients treated with hyperbaric oxygen and summarized their assessment of the state of clinical evidence.

Framingham Heart Study

Started in 1948, and now a project of the National Heart, Lung and Blood Institute and Boston University, the Framingham Heart Study has followed over 5,000 men and women and their offspring, spanning three generations, living in Framingham, Massachusetts. The study continues to help researchers identify the major risk factors of cardiovascular disease. The Framingham website includes risk score calculators and other tools for patients.

Clinical Resources

Start with the following resources to explore current research activities and the peer-reviewed medical literature on hyperbaric oxygen therapy for acute coronary syndrome (ACS).

 Use the search buttons below to go directly to research on hyperbaric oxygen therapy.
National Institutes of Health keeps the official list of human clinical trials currently enrolling, in progress, and recently completed. One may reasonably question the size and legitimacy of any study not listed here.



An independent, international, nongovernmental organization, Cochrane is a powerful force in evidence-based medicine. One may consider a Cochrane article on any HBOT topic required reading. Read the full 2014 Intervention Review: Hyperbaric oxygen therapy for acute coronary syndrome, doi:10.1002/14651858.CD004818.pub4

Google Scholar

A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals. Google Scholar may produce many search results, but entries provide easy access to full-text journal articles.

Search Google Scholar


HBOEvidence uses computerized tools to appraise the key randomized controlled trials (RCTs) in the hyperbaric medical literature. One may reasonably question the overall strength of HBOT evidence for any disease or condition not covered here.

Search HBOEvidence
US National Library of Medicine, US National Institutes of Health

PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and legitimacy of any study not listed here.



News About Acute Coronary Syndrome and Hyperbaric Oxygen Therapy

More news from O2.0 – the HyperbaricLink blog

Complete acute coronary syndrome news archive from O2.0 — the HyperbaricLink blog

Further Reading

HyperbaricLink suggests HeartHub the American Heart Association's patient portal.

Related Terms

  • Angina
  • Cardiac arrest
  • Cardiovascular disease
  • Cholesterol
  • Coronary artery disease
  • Coronary thrombosis
  • Heart attack
  • Lipids
  • Lipoproteins
  • Myocardial infarction
  • Myocardial ischemia
  • Stroke
  • Sudden cardiac death
  • Unstable angina


American Heart Association, Acute Coronary Syndrome. Retrieved 02 May 2015.
Bennett MH, Lehm JP, Jepson N. Hyperbaric oxygen therapy for acute coronary syndrome.
Cochrane Database of Systematic Reviews 2011. Retrieved 02 May 2015.
Page Data
Updated: 28 Jul 2015 04:38 PM
Created: 03 Sep 2011 11:12 AM
By: About the authors »