DrMKZ

“Selamat pagi Cikgu, membaca itu jambatan ilmu” – Lagu ‘Ciao’ Joe Flizzow.

ESC new guideline 2026.

1. Fifth Universal Guideline of Myocardial Infarction from slides.

kita start with Universal Defintion of MI perubahan terminology dan approach.

Mari mentelaah ilmu-ilmu guideline baru ini.

dah take classification yang lama, nak compile into 3 je. Primary, Secondary and Procedure related. Primary so that, prioritazation, avoing missing primary acute. ? any changes.. i wonder.

type II mi dah takpakai term ni. Pakai new term secondary MI. supply demand imbalance. – obstructive CA without Acute coronary pathology or new/presumed wall motion abnormality or absence of viable myocardium.

Type 3 MI dah removed

Type 4 and Type 5 jadi Procedure related MI

sekarang ada term myocardial injury .

haha dulu ada jugak.

cathecholamine stress… ni hati hati bang. ni la yang tak pasal bagi thrombolysis. takutsubo.

stroke, epileptic seizures, sub arachnoid haemarrhoge.

cardiac contusion. ada kes, ST segment up post poly trauma.

Chronic myocardial injury, associated with cardiac modelling. stable conditioned.

Diagnosis is Likely or confirmed

confirmed in atherothrombosis, spontaneous coronary artery dissection, vasospamsm, embolism, thrombosis – feature on imaging.

alternative acute condition resulting in myocardial oxygen supply -demand mismatch. sepsis, severe sepsis.

clinical status, comorbidities, diagnostic uncertainty,… hehe certainty. 🙂

keyword, myocardial supply demand mismatch. decresease myocardial vs increase myocaridla demand = myocardial injury. acute myocardial injury.

ada procedure, ada myocardial injury.

keyword 30 days.

sudden death, tetiba VF.

bukan new RBBB ye. new LBBB. possible acute coronary occlusion. Sgarbossa criteria.ish ish..

ST segment 2.5 in <40 years

ST segment 2 in >40 years male

ST 1.5 in female

de Winter haha.. Tall prominent symmetrical with upsloping segment depression

Wellens Biphasic or deeply inverted T

Sgarbossa – ST segment >5 mm not cordant.

time frame. ada early. ada just nice. ada late presentation.

Troponitis. hahah. semua asyik nak hantar troponins.

we are entering cardiac mri age.

ni kena belajar ni.. haha macam tak tahu je. kena belajar baca.

keyword AI and machine learning for ECG, Cardiac biomarkers.

Assay specifi untuk chronic myocardial injury.. maybe tak de lagi assay nak tahu ni acute ke chronic ni.. ntah ntah acute myocardial yang lepas.

…

lagu last hari ni..

ni baru 1 ada 3 lagi guidelines.