Classification of myocardial infarction
What are the 4 types of myocardial infarction?
ST segment elevation myocardial infarction (STEMI) non-ST segment elevation myocardial infarction (NSTEMI) coronary spasm, or unstable angina.
What are the 2 major types of myocardial infarction and how are they different?
Type 1 MI is a primary coronary arterial event attributable to atherothrombotic plaque rupture or erosion. Type 2 MI occurs secondary to an acute imbalance in myocardial oxygen supply and demand without atherothrombosis.
What are the classifications of acute coronary syndrome?
Non-ST-elevation myocardial infarction (NSTEMI), ST-elevation MI (STEMI), and unstable angina are the three traditional types of ACS.
What are the stages of myocardial infarction?
The myocardial infarction process can be divided into 2 phases, an early evolving phase (the first 6 hours) and a later convalescent phase. An evolving infarction is associated with an occluded coronary artery; in most cases, a thrombotic occlusion occurs.
What are the 3 stages of myocardial infarction?
Acute myocardial infarction with rupture, gross. Acute myocardial infarction with rupture and tamponade, gross. Intermediate (healing) myocardial infarction (1 – 2 weeks), microscopic. Remote myocardial infarction (3 to 4 weeks), microscopic.
What is a Type 3 myocardial infarction?
The type 3 myocardial infarction was defined according to the Universal definition of myocardial infarction, that is, cardiac death with symptoms suggestive of myocardial ischemia and presumed new ischemic ECG changes or new left bundle branch block, but death occurring before blood samples could be obtained, before …
What are the five types of myocardial infarction?
|The Third Universal Definition of Myocardial Infarction|
|Type 4b:||Myocardial infarction related to stent thrombosis|
|Type 4c:||Myocardial infarction related to restenosis|
|Type 5:||Myocardial infarction related to coronary artery bypass grafting (CABG)|
What is the pathogenesis of MI?
In the clinical context, myocardial infarction is usually due to thrombotic occlusion of a coronary vessel caused by rupture of a vulnerable plaque. Ischemia induces profound metabolic and ionic perturbations in the affected myocardium and causes rapid depression of systolic function.
What is the difference between Type 1 and Type 2 myocardial infarction?
Type 1 myocardial infarction occurs in those with atherosclerotic plaque rupture and thrombosis, whereas type 2 myocardial infarction occurs due to myocardial oxygen supply and demand imbalance in the context of an acute illness causing tachyarrhythmia, hypoxia, or hypotension without acute atherothrombosis.
What is a Type 2 myocardial infarction?
Type 2 myocardial infarction (MI) is defined by a rise and fall of cardiac biomarkers and evidence of ischemia without unstable coronary artery disease (CAD), due to a mismatch in myocardial oxygen supply and demand. Myocardial injury is similar but does not meet clinical criteria for MI.
What is a Type 1 myocardial infarction?
Type 1. Type 1 MI is due to acute coronary atherothrombotic myocardial injury with either plaque rupture or erosion and, often, associated thrombosis. Most patients with ST-segment elevation MI (STEMI) and many with non-ST-segment elevation MI (NSTEMI) fit into this category.
What is STEMI and NSTEMI?
STEMI results from complete and prolonged occlusion of an epicardial coronary blood vessel and is defined based on ECG criteria..NSTEMI usually results from severe coronary artery narrowing, transient occlusion, or microembolization of thrombus and/or atheromatous material.
Is Type 1 or Type 2 MI worse?
Compared with type 1 MI, patients with type 2 MI had significantly worse survival free from cardiovascular death over long-term follow-up (unadjusted HR: 2.0; 95% CI: 1.6 to 2.7; p < 0.001).
Is Type 1 MI STEMI?
Type 1 MI is due to acute coronary atherothrombotic myocardial injury with plaque rupture. Most patients with ST-segment elevation MI (STEMI) and many with non-ST-segment elevation MI (NSTEMI) comprise this category.
What is troponin level?
A troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
Can a Type 2 MI be a STEMI?
Causes of Type II MI
Sepsis as a cause of type-II MI was more common among patients presenting with STEMI compared with those presenting with NSTEMI (40.7% vs. 19.2%, p = 0.02). Other causes did not differ between STEMI and NSTEMI patients.
What is the gold standard test for myocardial infarction?
Cardiac troponin I
Cardiac troponin I: the gold standard in acute myocardial infarction diagnosis.
What is acute and chronic MI?
Acute myocardial infarction was defined as occurring less than 30 days, subacute as occurring between 30 days and 1 year, and chronic as occurring more than 1 year since the initial presentation of the patient with acute coronary syndrome.
Why is troponin elevated in MI?
An increased level of the cardiac protein isoform of troponin circulating in the blood has shown to be a biomarker of heart disorders, the most important of which is myocardial infarction . Raised troponin levels indicate cardiac muscle cell death as the enzyme is released into the blood upon injury to the heart.
Is troponin elevated in STEMI?
In STEMIs, patients will have an elevated troponin as well as one of the following ECG changes: (1) ST-segment elevations greater than 1 mm in contiguous leads with reciprocal changes, (2) new evidence of a left bundle branch block, or (3) ST-segment elevations noted on a posterior ECG.
Is myocarditis a Type 2 MI?
Type 2 MI is distinguished from myocardial injury without acute ischemia, for example, acute heart failure and myocarditis.
Which enzyme raised first in MI?
Troponins are the most widely recognized and important cardiac enzymes used in the diagnosis of acute myocardial ischemia in modern medicine. The majority of patients with an acute MI will have elevation in troponins within 2 to 3 hours of arrival at the emergency department, versus 6 to 12 hours with creatine kinase.