Cardiology Groups Revamp Heart Attack Diagnosis to Better Include Women's Symptoms

Four leading cardiology organizations have agreed on new criteria for diagnosing heart attacks, focusing on forms more commonly affecting women. This was announced at the European Society of Cardiology congress in Munich. The European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA), and World Heart Federation (WHF) have established these new diagnostic standards.

Previously, heart attack diagnoses mainly focused on coronary arteries blocked by clots, a condition more prevalent in men. The new criteria expand the scope to include other causes of reduced blood flow to the heart, such as coronary artery spasms, embolisms, and spontaneous coronary artery dissection (SCAD). Coronary spasms, which can be triggered by stress, physical exertion, or extreme cold, involve the contraction of an artery, reducing blood and oxygen supply to the heart. Coronary embolism occurs when a clot or fat deposit blocks an artery, while SCAD involves a rupture in the artery wall. Approximately 80% of SCAD cases occur in women, often around pregnancy, according to The Guardian.

A significant aspect of the new guidelines is the adjustment of troponin level criteria, a protein released when heart muscle is damaged. Previously, the same troponin threshold was applied to both men and women, leading to missed diagnoses in women. The new recommendations set different troponin values based on sex, aiming to catch heart attack cases in women that were previously overlooked.

Professor Bryan Williams described the change as a 'turning point, a radical change' that 'will transform patient care.' Professor Nicholas Mills, who coordinated the international group, highlighted that this is the first global agreement on heart attack diagnostic criteria. Mills emphasized the previous 'unintentional systematic bias against women' due to uniform troponin thresholds, which resulted in missed diagnoses.

The new recommendations have been published in the European Heart Journal. Specialists hope these criteria will improve the diagnosis and treatment of heart attacks, particularly in women, by addressing forms that were historically underrecognized.