Criteria for acute, evolving or recent MI

Either one of the following criteria satisfies the diagnosis for an acute, evolving or recent MI:

1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical markers of myocardial necrosis with at least one of the following:

1. ischemic symptoms;

2. development of pathologic Q waves on the ECG;

3. ECG changes indicative of ischemia (ST segment elevation or depression); or

4. coronary artery intervention (e.g., coronary angioplasty).

2) Pathologic findings of an acute MI.

 

Criteria for established MI

Any one of the following criteria satisfies the diagnosis for established MI:

1) Development of new pathologic Q waves on serial ECGs. The patient may or may not remember previous symptoms. Biochemical markers of myocardial necrosis may have normalized, depending on the length of time that has passed since the infarct developed.

2) Pathologic findings of a healed or healing MI.

References:

1. Joint European Society of Cardiology/American College of Cardiology Committee.. Myocardial infarction redefined. A consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 2000; 21: 1502-1513

2. Ferguson JL, Beckett GJ, Stoddart M, Walker SW, Fox KA. Myocardial infarction redefined: the new ACC/ESC definition, based on cardiac troponin, increases the apparent incidence of infarction. Heart 2002 Oct;88(4):343-7

3. Lopez-Sendon J, Lopez De Sa E. New diagnostic criteria for myocardial infarction: order in chaos. Rev Esp Cardiol 2001 Jun;54(6):669-74