Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a condition called type 2 myocardial infarction (T2MI). As with any MI subtype, there must be clinical evidence of myocardial ischemia to make the diagnosis. This condition is increasingly diagnosed due to the increasing sensitivity of cardiac troponin assays and is associated with adverse short-term and long-term prognoses. Limited data exist defining optimal management strategies because T2MI is a heterogeneous entity with varying etiologies and triggers. Thus, these patients require individualized care. A major barrier is the absence of a uniform definition that can be operationalized with high reproducibility. This document provides a synthesis of the data about T2MI to assist clinicians' understanding of its pathobiology, when to deploy the diagnosis, and its associated treatments. It also clarifies prognosis, identifies gaps in knowledge, and provides recommendations for moving forward.

中文翻译：

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2型心肌梗塞

在没有急性动脉粥样硬化斑块破坏的情况下，心肌需氧量增加和/或供应减少可能会导致急性心肌梗死 (MI)；一种称为 2 型心肌梗塞 (T2MI) 的病症。与任何 MI 亚型一样，必须有心肌缺血的临床证据才能做出诊断。由于心肌肌钙蛋白测定的敏感性增加，这种情况越来越多地被诊断出来，并且与不利的短期和长期预后相关。定义最佳管理策略的数据有限，因为 T2MI 是一个具有不同病因和触发因素的异质实体。因此，这些患者需要个性化护理。一个主要的障碍是缺乏可以以高重现性操作的统一定义。本文档提供了有关 T2MI 的数据综合，以帮助临床医生了解其病理生物学、何时部署诊断及其相关治疗。它还阐明了预测，确定了知识差距，并提供了前进的建议。