Major cardiac societies adopt new universal heart attack definition

Four major cardiovascular organizations—the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation—have introduced the Fifth Universal Definition of Myocardial Infarction. Presented at the ESC Congress in Munich, the new guidelines replace the previous five-number classification system with three broader clinical categories focused on the underlying cause of the event.

The update aims to address systematic biases and diagnostic inconsistencies. Specifically, the new definition upgrades the classification of three heart attack types that are significantly more common in women: coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection (SCAD). Under previous systems, these were often ranked lower than traditional clot-caused attacks, which could lead to inadequate care for female patients.

Additionally, the guidelines introduce a lower threshold for troponin blood tests. The previous single threshold was found to be effective for men but often missed heart attacks in women. By focusing on the clinical setting and the specific mechanism of injury, the new international standard seeks to improve diagnosis, communication, and research consistency globally.