Primary, secondary or procedure-related: 3 new settings for classifying heart attacks explained

A heart attack, medically known as a myocardial infarction (MI), is a serious cardiovascular event that can have varying causes. Four renowned international cardiac organizations have collaborated to introduce a more simplified classification system for heart attacks, aiming to enhance diagnosis, treatment, and patient communication.

The Fifth Universal Definition of Myocardial Infarction, developed jointly by the European Society of Cardiology, American College of Cardiology, American Heart Association, and World Heart Federation, categorizes MI into three primary settings: primary, secondary, and procedure-related.

Primary MI occurs spontaneously due to an acute issue within a coronary artery, often caused by atherosclerotic plaque rupture or coronary wall tears. Secondary MI results from an imbalance in oxygen supply and demand within the heart, triggered by other conditions like extreme blood pressure fluctuations or abnormal heart rhythms. Procedure-related MI arises within 30 days of cardiac procedures such as stenting or bypass surgery.

Experts emphasize that this new classification prioritizes understanding the reasons behind the heart attack rather than the traditional numerical system. Dr. Parin Sangoi, a consultant interventional cardiologist, highlights that this approach acknowledges that heart attacks can present differently in individuals, particularly women.

Dr. Punya Pratap Kujur, a consultant cardiologist, notes that this distinction is crucial for providing individualized care, as certain mechanisms of heart attacks may require different treatments. Women, in particular, may experience heart attacks due to conditions like spontaneous coronary artery dissection (SCAD), coronary artery spasm, or embolism, which may not always result in a severely blocked artery.

To be proactive about heart health, Dr. Sangoi advises women to recognize and not ignore symptoms beyond the typical crushing chest pain, such as breathlessness, fatigue, nausea, sweating, dizziness, or discomfort in the jaw, back, shoulder, or arm. Regular monitoring of blood pressure, blood sugar, and cholesterol, maintaining a healthy lifestyle, and adhering to prescribed treatments are essential for prevention.

The success of these guidelines hinges on consistent implementation and increased awareness among both medical professionals and patients.