Why “heart attack” has been redefined—and why that will save more women

“If we use the same threshold, we risk missing myocardial injury and underdiagnosing myocardial infarction. By having the sex specific threshold, we eliminate systematic bias or underdiagnosis.”

“Imagine a woman comes to the hospital with chest pain, and her blood test shows that she has some kind of injury to the heart muscle, but when they look at the coronary arteries, they don't find any major blockage. Further testing, such as a cardiac MRI, can help determine whether she had a heart attack or another cause of heart injury, such as inflammation of the heart muscle. So that change from heart attack to heart injury reinforces that MINOCA is a working diagnosis, not a final diagnosis. Finding no major blockage does not mean the evaluation is finished.”

“A woman who presents with a heart attack is more likely to have a cause that is not related to cholesterol plaque buildup, particularly if they are younger or if their heart attack occurs during pregnancy or after a pregnancy. This new definition will help us recognise some of these female dominant causes, and in this way, we can improve the diagnosis and treatment of these conditions for women.”