Symptoms / Diagnosis
The development of more sensitive assays for markers as well as new imaging techniques, both of which can detect even very small amounts of myocardial injury or necrosis, has necessitated re-evaluation of established definitions of myocardial infarction (MI), particularly when such necrosis occurs in the setting of the critically ill, after percutaneous coronary procedures or after cardiac surgery.
According to the universal definition of an acute myocardial infarction of the Joint ESC/ACCF/AHA/WHF Task Force, the term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischaemia.1
Myocardial infarction (MI) is not always accompanied by the onset of sudden, intense symptoms. In contrast, most often it starts slowly, with mild pain or discomfort.
Following with the Joint ESC/ACCF/AHA/WHF Task Force definition of acute myocardial infarction, any one of the listed criteria meets the diagnosis for MI:1
- Thygesen et al. ESC/ACCF/AHA/WHF Third Universal Definition of Myocardial Infarction 2012. J Am Coll Cardiol 2012;60(16):1581-1598.