Why the study?
The Fourth Universal Definition of Myocardial Infarction placed less emphasis on updating ECG changes related to MI, despite ECG being the main tool for detecting ischemia, triage, and risk stratification.
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Design
Review
FUDMI's reduced ECG emphasis may limit acute MI specificity without CMR; leaves open need for updated ECG validation studies.
The Fourth Universal Definition of Myocardial Infarction (FUDMI) focuses on the distinction between nonischemic myocardial injury and myocardial infarction (MI), along with the role of cardiovascular magnetic resonance, in order to define the etiology of myocardial injury. As a consequence, there is less emphasis on updating the parts of the definition concerning the electrocardiographic (ECG) changes related to MI. Evidence of myocardial ischemia is a prerequisite for the diagnosis of MI, and the ECG is the main available tool for (a) detecting acute ischemia, (b) triage, and (c) risk stratification upon presentation. This review focuses on multiple aspects of ECG interpretation that we firmly believe should be considered for incorporation in any future update to the Universal Definition of MI.
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Birnbaum et al. (2020) studied this question.
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