How to clinically differentiate between MI and myocardial injury

Updated definitions have been released by an international task force

The diagnosis of myocardial infarction requires more than an elevation in cardiac troponin values, which, in isolation, reflects only myocardial injury, according to the 2018 fourth universal definition of the cardiac event.

Representatives from the Joint European Society of Cardiology/American College of Cardiology/American Heart Association/World Heart Federation task force updated the 2012 definition of myocardial infarction with a focus on distinguishing it from myocardial injury.

Detecting an elevated cardiac troponin value above the 99th percentile upper reference limit constitutes myocardial injury, which can arise from ischaemic and non-ischaemic causes.

Myocardial injury is considered acute if there is a rise and/or fall of cardiac troponin values.

However, a diagnosis of infarction requires a rise and/or fall in cardiac troponin values with at least one value