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36 CRITICAL ILLNESSES 

or DREAD DISEASES

DEFINITION OF THE DREAD DISEASE -

2.  HEART ATTACK (MYOCARDIAL INFARCTION)

The death of a portion of the heart muscle due to Myocardial Infarction resulting in Class III or Class IV functional impairment (based on the New York Heart Association Classifications).  Non q-wave infarctions and early Myocardial Infarctions with subsequent thrombolytic therapy are excluded unless there is clear evidence by angiography of a Myocardial Infarction additionally to the other specific M1 conditions.

Class III and IV functional impairment as per New York Heart Association Classification are as follows:

Class III.    Marked limitation - Such patients are comfortable at rest but performing less than ordinary activity will lead to symptoms of Congestive Cardiac Failure.

Class IV.    Inability to carry out any activity without discomfort.  Symptoms of Congestive Cardiac Failure are present even at rest.  With any increase in physical activity, discomfort will be experienced.

The diagnosis of Myocardial Infarction will be based on the following criteria:

1. a history of typical chest pain;

2. new electro-cardiographic changes; and

3. elevation of cardiac enzymes.

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