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.

4th Update of Myocardial Infarction Definition

Experts' Introduction

To correctly diagnose acute myocardial infarction in a patient with symptoms giving suspicion of myocardial ischemia is very important for the appropriate management and treatment.

The diagnosis is still in the vast majority of cases based on the history, ECG and measurement of cardiac troponin (cTn).

The use of very sensitive cTn assays has increased the possibility to detect even very small myocardial infarctions and to make the diagnosis much earlier after symptom onset.

However, it has also become evident that elevation of cTn is very common also in the absence of evidence of myocardial ischemia.

Therefore, the term myocardial injury has been coined. In the Fourth universal definition of myocardial infarction from 2018 the differentiation of myocardial infarction from myocardial injury is discussed in detail.

Furthermore, the criteria for the different subtypes of myocardial infarction (type 1-5) has been updated.


lindahl-2013.jpgProf. Bertil Lindahl, M.D., Ph.D., FESC

Department of Cardiology,

Uppsala Clinical Research center och Institutionen för Medicinska Vetenskaper, Sueden


Mohammad El Tahlawi.jpgResources below have been selected by Dr. Mohammad El Tahlawi

Young Member



E-learning Courses

escel-acca.jpgTopic 37. Biomarkers in Acute Coronary syndromes




Acute Cardiovascular Care Congress Resources

ESC 365Resource from Acute Cardiovascular Care 2019:



ESC Congress Resources

A selection of resources from ESC congresses:



ESC Webinar on:

STEMI: the most important changes in the current guidelines




ESC Clinical Practice Guidelines


ESC Guidelines on

Fourth Universal Definition of Myocardial Infarction Guidelines




ACVC Scientific Poster

Download the scientific poster on "Fourth Universal Definition of Myocardial Infarction Essentials for clinical practice" (restricted to ACVC Ivory, Silver and Gold Members)

European Heart Journal

What’s new in the Fourth Universal Definition of Myocardial infarction?