In the Emergency Department, the diagnosis of acute myocardial infarction (AMI) relies initially on a patient’s history and the 12-lead electrocardiogram (ECG). Establishing the diagnosis of AMI in the left bundle branch block (LBBB) is difficult and can result in delay of definitive treatment. In 1996, Sgarbossa found 3 ECG criteria to evaluate for AMI in patients with LBBB.
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Killip-Kimball Classification for Acute Myocardial Infarction
The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU).
Universal Definitions of Myocardial Injury and Myocardial Infarction
With the introduction of more sensitive cardiac biomarkers, the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) collaborated to redefine MI using a biochemical and clinical approach, and reported that myocardial injury detected by abnormal biomarkers in the setting of acute myocardial ischaemia should be labelled as MI.
TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)
The TIMI risk score, based upon data from 15,000 patients with an ST segment elevation myocardial infarction eligible for fibrinolytic therapy, is a simple arithmetic sum of eight independent predictors of mortality.
Diagnostic Criteria of Infarction in MRI of the Brain in Acute Stroke
Acute: Subtle low signal (hypointense) on T1, often difficult to see at this stage, and high signal (hyperintense) on spin density and/or T2-weighted and proton density-weighted images starting 8 h after onset; should follow vascular distribution. Mass effect maximal at 24 h, sometimes starting 2 h after onset, even in the absence of parenchymal signal changes. No parenchymal enhancement with paramagnetic contrast agent. Territorial intravascular paramagnetic contrast enhancement of “slow-flow” arteries in hyperacute infarcts; at 48 h, parenchymal and meningeal enhancement can be expected.
Diagnostic Criteria of Infarction in CT Imaging of the Brain in Acute Stroke
Computed tomography (CT) is widely used for early evaluation of acute strokes. Most importantly, CT excludes acute hemorrhage or other diseases mimicking ischemia.
New Diagnostic Criteria for Myocardial Infarction (MI)
Criteria for acute, evolving or recent MI
Either one of the following criteria satisfies the diagnosis for an acute, evolving or recent MI:
1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical markers of myocardial necrosis with at least one of the following: