Medical organizations representing cardiology worldwide have unveiled revised guidelines for diagnosing and managing heart attacks in response to longstanding disparities in how women receive treatment. The landmark agreement was unveiled at the annual congress of the European Society of Cardiology in Munich and represents the first globally coordinated approach to defining and classifying heart attacks.
The new framework addresses three types of heart attacks that research indicates occur more frequently in women than men. These conditions—coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection—have historically been classified as less urgent despite evidence that delays in recognizing and treating them can have serious consequences. Spontaneous coronary artery dissection accounts for approximately 80% of cases in women and often occurs during or shortly after pregnancy.
A significant component of the updated guidelines involves adjusting diagnostic thresholds for women based on troponin levels, a protein released when the heart sustains injury. Previously, women were required to reach the same blood protein threshold as men before receiving a heart attack diagnosis, a practice that medical experts now recognize as creating systematic diagnostic bias. The revised approach recognizes that some less common causes of reduced blood flow to the heart—including arterial tearing, narrowing, or blockage—may be missed under prior protocols.
Professionals involved in developing the guidelines characterized the changes as transformative for patient care. Officials from the British Heart Foundation noted that the revisions address decades of diagnostic inequities and could prove life-changing for substantial populations globally. The updated classifications also aim to help patients better understand their condition and treatment options.
The guidelines were developed by representatives from four major international cardiovascular health organizations: the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation. Officials emphasized that implementing these standards consistently across healthcare systems worldwide would be essential to realizing improvements in care delivery.
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