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. 2020 Dec 29;268(6):2284–2292. doi: 10.1007/s00415-020-10349-w
Myocardial injury Presence of elevated cardiac troponin value above the assay-specific 99th percentile upper reference limit (URL)
Chronic myocardial injury Myocardial injury but no acute change in serial measurement
Acute myocardial injury Myocardial injury with rise or fall (> 20%) in serial measurement
Acute myocardial infarction

Acute myocardial injury with clinical evidence of acute myocardial ischemia:

- Symptoms of myocardial ischemia (e.g. chest pain)

- New ischemic ECG changes

- Development of pathological Q waves

- Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischemic etiology;

 Identification of a coronary thrombus by angiography or autopsy

Type 1 myocardial infarction Myocardial infarction caused by atherothrombotic coronary artery disease and usually precipitated by atherosclerotic plaque disruption (rupture or erosion)
Type 2 myocardial infarction

Myocardial infarction caused by a mismatch between oxygen supply and demand by a pathophysiological mechanism other than coronary atherothrombosis

(e.g. tachyarrhythmia, hypotension or shock, severe anemia)

Acute non-ischemic myocardial injury Myocardial injury in the absence of an ischemic cause (i.e. no evidence of myocardial ischemia as described above in myocardial infarction)
Takotsubo Syndrome (TTS) Acute but mostly reversible heart failure syndrome that can mimic myocardial infarction. TTS is often triggered by a preceding emotionally or physically stressful event. The pathophysiologic mechanism is thought to be a strong sympathetic stimulation with overshooting catecholamine levels. Over 90% of patients with TTS are postmenopausal women
Stroke-heart syndrome Evidence of acute myocardial injury, cardiac dysfunction, or cardiac arrhythmia within 30 days after acute ischemic stroke with peak within 72 h and potential long-term cardiac sequelae. Cardiac symptoms are either newly detected after the ischemic stroke event, or clear evidence shows worsening of cardiac function after stroke. Needs to be differentiated from type 1 MI and systemic causes of non-ischemic myocardial injury