Revised heart attack definition could improve diagnoses for women

The revised Fifth Universal Definition of Myocardial Infarction, recently published in the European Heart Journal and Journal of the American College of Cardiology, aims to improve heart attack diagnoses, particularly for women. This change replaces the previous numerical system with three broader categories: primary, secondary, and procedure-related heart attacks, reflecting more accurately the various ways heart muscle can lose its blood supply.

For women, this is crucial as traditional heart attacks, characterized by a blood clot blocking a coronary artery, are less common among them. Alternative causes, such as spontaneous coronary artery dissection (SCAD), sudden arterial spasms, or embolisms, disproportionately affect women and are now clearly classified under the updated definition.

This shift provides doctors with a clearer framework to recognize different heart attack types, potentially leading to more appropriate treatment strategies. Additionally, the new guidance emphasizes the use of gender-specific troponin thresholds, addressing a known issue where the same cutoff for all patients can lead to heart injury and missed diagnoses in female patients.

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