Global updates to cardiovascular diagnostic definitions

Global cardiology and cardiovascular organizations have introduced updated universal definitions for heart failure and heart attacks to improve diagnostic accuracy and care consistency.

In late August 2026, a consensus published in the journal Circulation revised the definition of heart failure. This update emphasizes that a ‘normal’ ejection fraction may not guarantee cardiac health, as it can mask structural or functional abnormalities. The goal is to improve early prevention and treatment for the syndrome, which affects over 55 million people globally.

Following this, four major organizations—the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation—introduced the ‘Fifth Universal Definition of Myocardial Infarction’ at the ESC Congress in Munich. This overhaul replaces the previous five-number classification system with three broader clinical categories focused on the underlying cause of the event.

The new guidelines specifically address historical disparities in care for women by prioritizing conditions such as coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection (SCAD). These conditions occur at rates up to 10 times higher in women than in men and are often triggered by childbirth, exercise, or emotional stress rather than traditional clot-based blockages. To prevent diagnostic delays, the guidelines adjust the diagnostic threshold for troponin, a protein released during heart tissue damage, by implementing a lower threshold for women to ensure these specific types of attacks are not missed or deprioritized.