Abstract: Driven by global warming, the increasing frequency of high temperatures and heat waves poses a severe public health challenge to cardiovascular health. A substantial body of epidemiological evidence indicates that exposure to high temperatures and heat waves significantly increases the risk of both incidence and mortality from acute coronary syndrome (ACS). This risk is often amplified by the synergistic effects of environmental factors such as air pollution, imposing a heavier burden on vulnerable populations, including the elderly and individuals with chronic diseases. The primary mechanisms include inducing heat stress, hemoconcentration, increasing cardiovascular load, activating inflammatory responses, and destabilizing coronary artery plaques. To address this climate-related health crisis, future research is urgently needed to further elucidate these pathways of action, individual susceptibility variability, and combined exposure. Additionally, based on this knowledge, precision public health practices should be implemented, including the development of dynamic early-warning systems integrating meteorological and health data, the implementation of resource allocation and targeted health education for high-risk communities and vulnerable populations, and the establishment of a multidisciplinary, coordinated, and multi-tiered protective network to enhance overall response capacity and population health resilience.