Table 1: Diagnostic criteria for acute coronary syndrome.

STEMI

Symptoms of myocardial ischemia in association with

• Persistent ECG ST elevation and subsequent release of biomarkers of myocardial necrosis

• ST elevation at the J point in at least 2 contiguous leads of ≥ 2 mm (in men) or ≥ 1.5 mm (in women) in V2-V3, or ≥ 1 mm in other contiguous chest or limb leads

NSTEMI

Symptoms of myocardial ischemia in association with ST and/or T wave changes, ongoing pain, and elevated troponin T

Unstable angina

Symptoms of rest angina (> 20 min), new- onset angina of at least CCS* class III severity, or increasing angina (more frequent, longer in duration, or lower in
threshold with increase in 1 or more CCS class to at least class III severity), in association with:

• Non-diagnostic ECG or ST/T wave changes

• Normal troponin level

• Flow-limiting stenosis on coronary angiogram (if angiogram done)

*Canadian Cardiovascular Society