Type 1 & Type 2 AMIs - NEVER and ALWAYS statements

chamman@clarohealthcare.com

I need some expert information on AMIs.  I’m not a cardiac expert and hear people say some things with a NEVER or ALWAYS statement which always makes me curious.

Statements:   “A Type I MI is always a STEMI”  or   “A STEMI is always a Type I”   or   “A NSTEMI is NEVER a Type I MI”. 

1. I’m not sure these NEVER/ALWAYS statements are 100% true all the time.
2. Type 1 MI pertains to a primary coronary event which you would think it would cause a Q Wave or an ST segment elevation.  But is this ALWAYS true?
3. Could a Type 1 MI from a primary coronary event ever present itself with a non-elevated ST segment MI?????
4. Could a Type 2 MI ever present with an elevated ST segment due to extensive infarction/necrosis?????

vparent@emhs.org

The type of MI 1 or 2 refers to the cause of the MI-coronary atherosclerosis or demand ischemia. Either type could be NSTEMI or STEMI but in my experience, Type 2 is usually a NSTEMI. Check out the link below:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753007/

lprescott1

I agree with above- the typing of an MI is based on the etiology. Type 1 merely means an spontaneous MI and can be either a STEMI or NSTEMI. This article is helpful in describing the 3rd Universal definitions. 
https://www.world-heart-federation.org/wp-content/uploads/2017/05/ThirdUniversalDefinitionMI2012.pdf