Diagnosis and Assessment
Figure 2. Troponin Positivity and the Universal Definition of MI
Troponin Positive
3
SCD
Ischemic
Classification of MI Type
Myocardial
infarction
2
1
Non-ACS
ACS
• Classic AMI
▶▶ STEMI
▶▶ NSTEMI
Noncoronary
Coronary
• Hypoxia
• Global ischemia
• Hyperperfusion
• CT surgery
• Increased demand
(stable CAD lesion)
• Hypertension
(small vessel)
• Spasm
• Embolism
• Procedure related
▶▶ PCI
4
▶▶ CT surgery 5
Type 1: Ischemic myocardial
necrosis secondary to
plaque rupture (ACS)
Type 2: Ischemic myocardial
necrosis not due to
ACS
(eg, supply/demand
mismatch, coronary
spasm, embolism,
↑ or ↓ BP, anemia,
arrhythmia)
Type 3: Sudden cardiac death
Type 4: Procedure related
a) Secondary to PCI
b) From stent
thrombosis
Type 5: CABG related