![]() Type 1 and type 2 MIs are distinguished by pathophysiology. Classification of Myocardial InfarctionĪccording to the Fourth Universal Definition of Myocardial Infarction, a myocardial infarction (MI) is defined as an acute myocardial injury accompanied by symptoms of myocardial ischemia, signs of ischemia on an ECG, or evidence of a new regional wall motion abnormality. ![]() ST segment elevation myocardial infarctionĪnginal symptoms/chest pain at rest associated with myocardial necrosis, indicated by elevated cardiac biomarkers (see Cardiac Enzymes Topic Review) and ST segment elevations on the 12-lead ECG. ECG changes may include ST and T-wave abnormalities. Non-ST segment elevation myocardial infarctionĪnginal symptoms/chest pain at rest that are associated with acute myocardial necrosis, as identified by elevated cardiac biomarkers (see Cardiac Enzymes Topic Review) without ST segment elevations on the 12-lead ECG. With unstable angina, cardiac enzymes remain normal or are very minimally elevated. Anginal symptoms at rest, occurring without physical exertion. ![]() Previously stable exertional angina that now occurs with less physical exertion.New-onset exertional angina angina is considered unstable when it first occurs.Three different presentations of angina qualify as “unstable”: The clinical differences between the types of acute coronary syndromes are discussed below. With recent advances in interventional cardiology, the terms “transmural,” “non-transmural,” “Q wave MI,” and “non-Q wave MI” have fallen out of favor and are no longer recommended.
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