Type 2 myocardial infarction due to supply-demand mismatch.
Nino Mihatov, James L Januzzi, Hanna K Gaggin
Author Information
Nino Mihatov: Cardiology Division, Massachusetts General Hospital, Boston, MA.
James L Januzzi: Cardiology Division, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Baim Institute for Clinical Research, Boston, MA.
Hanna K Gaggin: Cardiology Division, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Baim Institute for Clinical Research, Boston, MA. Electronic address: hgaggin@mgh.harvard.edu.
The best-accepted definition of myocardial infarction (MI) is provided by statements from the Universal Definition of MI Global Task force. This article, now in its third iteration, defines MI as myocardial cell death due to prolonged myocardial ischemia. It further delineates an increasingly incident subclassification of MI known as type 2 MI (T2MI). T2MI identifies instances of myocardial necrosis in which an imbalance between myocardial oxygen supply and/or demand occurs for reasons other than atherosclerotic plaque disruption. While associated with considerable risk (comparable to that of type 1 MI, which has well-defined management strategies), the spectrum of potential etiologies for T2MI makes development of precise diagnostic criteria and therapeutic implications of the diagnosis challenging.
