Doctors agree first universal definition of heart attack, promising care 'revolution'
The world's four leading cardiology organisations have agreed new guidelines for diagnosing heart attacks aimed at improving care for women, whose heart attack types have long been deprioritised. The overhaul was announced at the European Society of Cardiology congress in Munich.
The world's four leading cardiovascular health organisations — the European Society of Cardiology (ESC), the American College of Cardiology, the American Heart Association and the World Heart Federation — have agreed the first universal definition of a heart attack. It marks one of the biggest procedural overhauls in the field in decades and could transform care for millions of women.
The announcement came on the opening day of the ESC's annual congress in Munich, the world's largest cardiology conference.
Why it matters for women
Historically, some less common types of heart attack that disproportionately affect women have been treated as lower priority, leading to worse treatment and care. The new guidelines upgrade the status of three types of heart attack that are up to 10 times more common in women and are often linked to childbirth, exercise or emotional stress: coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection (Scad). The last of these affects women at least 80% of the time and often occurs during or shortly after pregnancy.
Previously, the most serious category — formerly "type 1", now called "primary" heart attacks — prioritised cases caused by a blood clot blocking the heart's blood supply. The forms more common in women, caused by a tear or tightening of the arteries reducing blood flow, have often been missed or treated with less urgency.
The guidelines also lower the threshold used to diagnose a heart attack in women based on blood levels of the protein troponin. Previously, women were held to the same threshold as men, meaning some cases in women went undetected.
Prof Bryan Williams, chief scientific and medical officer of the British Heart Foundation, called it a landmark, radical shift, noting that women have missed out on accurate diagnosis and treatment for decades. Prof Nicholas Mills of the University of Edinburgh, who led the international taskforce behind the guidelines, said it was the first time the world had agreed a truly global approach to diagnosing, classifying and explaining heart attacks, adding that the next task is to implement the changes as widely as possible.
The new guidelines were published in the European Heart Journal.
