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Classification of a Heart Attack

The European Society of Cardiology (ESC), American College of Cardiology (ACC), the American Heart Association (AHA) and the World Health Federation (WHF) have refined the definition of a heart attack/myocardial infarction by creating a clinical classification according to the assumed cause of the heart attack/myocardial infarction.

  • Type 1: MI consequent to a pathologic process in the wall of the coronary artery (e.g. plaque erosion/rupture, fissuring, or dissection)
  • Type 2: MI consequent to increased oxygen demand or decreased supply (e.g. coronary artery spasm, coronary artery embolus, anemia, arrhythmias, hypertension or hypotension)
  • Type 3: Sudden unexpected cardiac death before blood samples for biomarkers could be drawn or before their appearance in the blood
  • Type 4a: MI associated with percutaneous coronary intervention
  • Type 4b: MI associated with stent thrombosis
  • Type 5: MI associated with coronary artery bypass graft surgery