Review Notes
MYOCARDIAL INFARCTION
During some of our reviews, we have come across physicians describing a myocardial infarction based on a classification system. This is becoming much more common. Because of the increase use of this nomenclature, we would like to provide some additional information.
This system is based on the 2007 joint task force of the European Society of Cardiology, American College of Cardiology, the American Heart Association and the World Health Federation.
This task force outlined a more specific definition of an acute myocardial infarction and went on to develop a classification system outlining the types of myocardial infarctions than can occur.
Definition of acute myocardial infarction:
Clinical event consequent to the death of cardiac myocytes caused by ischemia, resulting from an imbalance between supply and demand
Clinical Classification:
- Type 1
MI consequent to a pathologic process in the wall of the coronary artery
(plaque erosion/rupture, fissuring or dissection) - Type 2
MI consequent to increased oxygen demand or decreased supply
(coronary artery spasm, coronary artery embolus, anemia, arrhythmias, hypertension or hypotension) - Type 3
Sudden unexpected cardiac death before blood samples for biomarkers could be drawn or before their appearance in the blood
- Type 4a
MI associated with PCI
- Type 4b
MI associated with stent thrombosis
- Type 5
MI associated with coronary artery bypass graft surgery
This information is provided to be used as an additional education piece of information and should never be substituted for physician documentation. As always, if there is ever question regarding the appropriate coding for a diagnosis, please query your physician.