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Comment & Response
January 2017

Refining the Diagnosis of Type 2 Myocardial Infarction—Reply

Author Affiliations
  • 1Division of Clinical and Translational Research, Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri
JAMA Cardiol. 2017;2(1):107. doi:10.1001/jamacardio.2016.3701

In Reply I appreciate the thoughtful interest and responses by Chapman and Mills as well as Sandoval and Jaffe to my Viewpoint on resolving the ambiguity of type 2 myocardial infarction (MI).1 The central argument I tried to make was that myocardial necrosis in the setting of myocardial ischemia but without evidence of coronary artery obstruction should not be classified as MI but rather as acute myocardial injury. The diagnosis of MI should be reserved for when there is evidence of coronary artery occlusion, obstruction, or flow limitation, consistent with how the term infarction is used in other organ systems.

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