Xu Bo, MacIsaac Andrew I
Department of Cardiology, St Vincent's Hospital, Melbourne, VIC, Australia.
Aust Fam Physician. 2013 Aug;42(8):554-9.
Myocardial infarction has a high rate of morbidity and mortality. There are major social, psychological and legal implications associated with the diagnosis of myocardial infarction (MI).
We present three case studies of different chest pain syndromes presenting with serum troponin elevation, and use these cases to form the basis of a review of the updated definition of MI. A practical approach to the diagnosis of myocardial infarction is also discussed.
The measurement of serum troponin levels was a great diagnostic advance and provided powerful prognostic information. Although elevated serum troponin levels were originally considered pathognomonic of MI, it has become clear that highly sensitive troponin assays detected the presence of elevated troponin levels in the absence of MI. This has led to the recent 'Third universal definition of myocardial infarction' consensus document.
心肌梗死的发病率和死亡率很高。心肌梗死（MI）的诊断涉及重大的社会、心理和法律问题。
我们展示了三例不同胸痛综合征伴血清肌钙蛋白升高的病例研究，并以此为基础对MI的最新定义进行综述。还讨论了心肌梗死诊断的实用方法。
血清肌钙蛋白水平的测定是一项重大的诊断进展，并提供了有力的预后信息。虽然血清肌钙蛋白水平升高最初被认为是MI的特征性表现，但现在很清楚，高敏肌钙蛋白检测在无MI的情况下也能检测到肌钙蛋白水平升高。这导致了最近的“心肌梗死第三次通用定义”共识文件的出台。
