Differentiating type-I vs. type-II MI
Sorting this out is difficult, often relying heavily on clinical judgement.
A key consideration is comparing the severity of physiologic stress vs. the severity of myocardial ischemia. For example, if you give someone 500 mcg of subcutaneous epinephrine and they develop transient chest pain and a troponin of 0.7 ng/ml, that's probably a type-2 MI. If the same symptoms developed in the absence of any stressor (chest pain and troponin elevation out of the blue), then that's probably a type-1 MI.
The table below includes some factors which can help guide this differentiation. Unfortunately, none of these factors in isolation are 100% reliable.
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