Cardiologists agree on the first universal definition of heart attack
Four leading international organizations in the field of cardiovascular health have agreed on the first universal definition of myocardial infarction. The new recommendations for medical professionals were presented in Munich on the first day of the annual congress of the European Society of Cardiology. As The Guardian reports, the changes are expected to improve the diagnosis and treatment of women whose heart attack cases may previously not have received proper attention.
Updated classification
Previously, type 1 heart attacks were considered the most serious, with priority given to cases caused by a blood clot blocking blood flow to the heart. Under the new system, such cases will be called primary heart attacks.
At the same time, the recommendations raise the importance of three types of heart attack which, according to medical professionals, occur up to ten times more often in women: coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection. These conditions are associated with reduced blood flow for other reasons, including the narrowing or rupture of an artery, and therefore may not have been detected or treated with the same urgency.
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Coronary artery spasm means narrowing of the artery, as a result of which the heart muscle does not receive enough blood and oxygen; it can be caused by emotional stress, physical exertion, or extreme cold. Coronary embolism occurs when a blood clot or fatty deposit travels to a coronary artery and blocks it. Spontaneous coronary artery dissection is caused by a tear in the artery; at least 80% of cases occur in women, and it often arises during pregnancy or shortly after childbirth.
Troponin threshold for women
The new guidelines also provide for a lower blood troponin threshold for diagnosing heart attacks in women. Troponin is a protein released when the heart muscle is damaged. Until now, the same threshold as for men was used for women.
University of Edinburgh cardiologist Nicholas Mills said that this approach involved unintentional systemic bias: the averaged threshold detected all men but could fail to detect some women. The recommendations were published in the European Heart Journal. The document was developed by the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation.
