Diagnostic and therapeutic implications of type 2 myocardial infarction: review and commentary.
The Task Force for the Universal Definition of Myocardial Infarction recently published updated guidelines for the clinical and research diagnosis of myocardial infarction under a variety of circumstances and in a variety of categories. A type 1 myocardial infarction (MI) is usually the result of atherosclerotic coronary artery disease with thrombotic coronary arterial obstruction secondary to atherosclerotic plaque rupture, ulceration, fissuring, or dissection, causing coronary arterial obstruction with resultant myocardial ischemia and necrosis. Patients with a type 2 MI do not have atherosclerotic plaque rupture. In this latter group of patients, myocardial necrosis occurs because of an increase in myocardial oxygen demand or a decrease in myocardial blood flow. Type 2 MI has been the subject of considerable clinical discussion and confusion. This review by knowledgeable members of the Task Force seeks to help clinicians resolve the confusion surrounding type 2 MI.
Sarver Heart Center, University of Arizona College of Medicine, Tucson. Electronic address: jalpert@shc.arizona.edu.
Joseph S
JS
Alpert
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Kristian A
KA
Thygesen
Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
Harvey D
HD
White
Mayo Clinic, Rochester, Minn.
Allan S
AS
Jaffe
D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003326:Coronary Circulation; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology*; D009336:Necrosis; D010101:Oxygen Consumption; D014336:Troponin / Q000097:blood
D015415:Biomarkers; D014336:Troponin
Clinical definition; Myocardial infarction; Troponin