01/09/2026
Having cooled down from the first external enthusiasm from the European Congress of Cardiology in Munich, I would like to move on to the professional plane and give an initial analysis of the adopted recommendations and new trends in cardiology.
And let's start with the 5th universal definition of myocardial infarction. This is not a classic recommendation - it is a direction of scientific and practical understanding of this most important pathology.
Since 2000, this is already the 5th definition and it seems quite successful. The last division of MI into 5 types did not take root in cardiological practice, despite the fact that it focused on the mechanisms of occurrence. But in practice it was cumbersome. And this is understandable.
The most persistent was and is the division into MI with and without ST segment elevation. This had practical significance in choosing treatment tactics. But it did not reveal pathogenetic mechanisms.
The proposal for the 5th definition of MI became the consensus of the three largest cardiological associations - two American and one European. It is simpler and more acceptable in practice.
It is tied to ICD 11.
It indicates the mechanisms of occurrence. It takes into account procedural MI as a new cardiological problem of recent decades.
5 universal definition of MI left the basis for understanding MI. MI is acute ischemia or necrosis of the heart muscle due to problems with the coronary arteries.
Which clearly separates this group from non-carcinogenic myocardial neuroses.
So MI was divided into primary, secondary and procedurally induced.
They gave fairly clear criteria for each category. The basis of diagnosis remains troponin with clearer criteria for men and women, clinical features and ECG.
Additionally, for all, visualization of the coronary arteries is classical coronarography or new MRI methods.
For the diagnosis of secondary MI, methods of visualization of myocardial ischemia zones are also used.
I personally liked the new approach. It is logical and promising. Therefore, I am sure that it will be accepted by practicing cardiologists, and it opens up new avenues for research.
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