The world’s four leading cardiovascular health organizations have established a new universal definition of heart attacks, addressing decades of disparities in how women receive care. The agreement, announced at the European Society of Cardiology’s annual congress in Munich, represents the most significant overhaul of heart attack classification and diagnosis standards in generations.
Historically, certain less common forms of heart attacks that disproportionately affect women have been classified and coded as lower priority within medical systems. This resulted in women receiving treatment approaches that often failed to address the specific underlying cause of their condition and sometimes worsened their health outcomes. The new guidelines seek to rectify this systematic bias by upgrading the classification status of three types of heart attacks that occur up to 10 times more frequently in women than men.
These three upgraded attack types—coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection—are commonly triggered by factors such as childbirth, emotional stress, exercise, and extreme cold. Spontaneous coronary artery dissection, which involves a tear in the coronary artery, occurs in 80% of cases among women, frequently during or shortly after pregnancy. By elevating the priority assigned to these conditions, the new framework aims to ensure faster diagnosis and more targeted treatment interventions.
A key modification involves adjusting the diagnostic threshold for troponin, a protein released when the heart sustains injury. Previously, women were required to reach the same blood level thresholds as men for heart attack diagnosis, which resulted in some cases being missed. The revised standards will implement sex-specific thresholds to improve diagnostic accuracy across gender lines. According to medical leaders involved in developing the guidelines, these changes represent a fundamental shift toward equitable care and should significantly reduce treatment delays that have had serious health consequences for women.
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