Diagnosis of AMI:

Either one of the following criteria satisfies the diagnosis for an acute, evolving, or recent MI as given by 2000 ESC/ACC consensus conference:

1.    Typical rise and gradual fall (cardiac troponin, at least one value above 99^th percentile of URL) or more rapid rise and fall (CK-MB) or biochemical markers of MI with at least one of the following:

a.      Ischemic symptoms

b.      Development of pathological Q waves on ECG

c.       ECG changes indicative of ischemia (ST elevation or depression)

d.      Coronary artery intervention (angioplasty)

2.      Pathological findings of an AMI.

ESC/ACC recommendations for use of cardiac biomarkers for detection of myocardial injury and MI are,

a.      Increase in biomarkers of cardiac injury is indicative of injury but not ischemia.

b.      Cardiac troponins (I or T) are preferred markers for diagnosis of MI.

c.       Increase in biomarkers indicates irreversible injury.

d.      MI is present if markers increase is 99^th percentile of normal range.

e.   Samples must be obtained at presentation; 6 to 9 hr and again 12-24 hour after symptoms begins.