Myocardial Infarction

What is Myocardial Infarction (MI)? Myocardial infarction (MI) refers to damage and death of the cells of the heart in response to ischemia caused by an inadequate supply of oxygen to the myocardium. Evidence of myocardial injury is defined by an elevation of the cardiac troponin levels by at least 1 value above the upper reference limit.

What are the Types of Myocardial Infarction?

 

The Joint Task Force of the European Society of Cardiology and the American College of Cardiology released the Fourth Universal Definition of Myocardial Infarction in 2018, which classifies myocardial infarction into 5 types. 

 

  • Type 1 MI is caused by ischemia from a primary acute coronary event, such as plaque erosion, or dissection or rupture of a coronary artery. Subtypes of Type 1 MI are STEMI and nSTEMI. 
  • Type 2 MI is associated with ischemia caused by increased oxygen demand or decreased supply unrelated to an acute coronary event 
  • Type 3 MI is sudden cardiac death caused by suspected MI prior to blood samples being taken or the appearance of biomarkers. 
  • Type 4a MI is associated with PCI
  • Type 4b MI is associated with stent thrombosis.
  • Type 5 MI is associated with CABG.

Source: Thygesen, K. S., Alpert, J. S., Jaffe, A. S., Chaitman, B. R., Bax, J. J., Morrow, D. A., & White, H. D. (2018). Fourth Universal Definition of Myocardial Infarction (2018). Circulation, 138(20). https://doi.org/10.1161/cir.0000000000000617