In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

Fourth Universal Definition of Myocardial Infarction Guidelines

ESC Clinical Practice Guidelines

Cardiovascular Surgery
Acute Cardiac Care
Interventional Cardiology
Diagnostic Methods
Cardiovascular Disease in the Elderly
Acute Coronary Syndromes
Guidelines version available to download
Published in 2018
Reference European Heart Journal 2018 doi:10.1093/eurheartj/ehy462
Published in 2018
Reference MI
Published in 2018
Reference Univ. Def of MI App
Published in 2019
Reference 29 Slides
Table of contents: Full Text (ESC Clinical Practice Guidelines)

Abbreviations and acronyms

1. What is new in the Universal Definition of Myocardial Infarction?

2. Universal definitions of myocardial injury and myocardial infarction: summary

3. Introduction

4. Pathological characteristics of myocardial ischaemia and infarction

5. Biomarker detection of myocardial injury and infarction

6. Clinical presentations of myocardial infarction

7. Clinical classification of myocardial infarction

7.1 Myocardial infarction type 1

7.2 Myocardial infarction type 2

7.3 Myocardial infarction type 2 and myocardial injury

7.4 Myocardial Infarction type 3

8. Coronary procedure-related myocardial injury

9. Myocardial infarction associated with percutaneous coronary intervention (type 4amyocardial infarction).

10. Stent/scaffold thrombosis associated with percutaneous coronary intervention (type 4bmyocardial infarction)

11. Restenosis associated with  percutaneous coronary intervention(type 4cmyocardial infarction)

12. Myocardial infarction associated with coronary artery bypass grafting (type 5myocardial infarction)

13. Other definitions of myocardial infarction related to  percutaneous coronary intervention or coronary artery bypass grafting

14.Recurrent myocardial infarction

15. Re-infarction

16. Myocardial injury and infarction associated with cardiac procedures other than revascularization

17. Myocardial injury and infarction associated with non-cardiac procedures

18. Myocardial injury or infarction associated with heart failure

19. Takotsubo syndrome

20. Myocardial infarction with non-obstructive coronary arteries

21 Myocardial injury and/or infarction associated with kidney disease

22. Myocardial injury and/or infarction in critically ill patients

23. Biochemical approach for diagnosing myocardial injury and infarction

24.Analytical issues of cardiac troponins

25. The 99th percentile upper reference limit

26. Operationalizing criteria for myocardial injury and infarction

27. Electrocardiographic detection of myocardial infarction

28. Application of supplemental electrocardiogram leads

29. Electrocardiographic detection of myocardial injury

30. Prior or silent/unrecognized myocardial infarction

31. Conditions that confound the electrocardiographic diagnosis of myocardial infarction

32. Conduction disturbances and pacemakers

33. Atrial fibrillation

34. Imaging techniques

34.1 Echocardiography

34.2Radionuclide imaging

34.3Cardiacmagnetic resonance imaging

34.4 Computed tomographic coronary angiography

35. Applying imaging in acute myocardial infarction

36. Applying imaging in late presentation of myocardial infarction

37. Regulatory perspective on myocardial infarction in clinical trials

38. Silent/unrecognized myocardial infarction in epidemiological studies and quality programmes

39. Individual and public implications of the myocardial infarction definition

40. Global perspectives of the definition of myocardial infarction

41. Using the Universal Definition of Myocardial Infarction in the healthcare system


43. Acknowledgements

44. References

Previous version available to download
Published in 2012
Reference European Heart Journal (2012) 33, 2551–2567