Letter by Rajtar-Salwa and Dimitrow Regarding Article, “Exercise and Hypertrophic Cardiomyopathy: Time for a Change of Heart”

Normal or nearly normal coronary angiogram does not rule out the presence of an acute coronary syndrome according to the third universal definition of myocardial infarction published in 2012. The authors of this definition conceptualized the mechanism of type 2 myocardial infarction as a derivate of an ischemic imbalance, myocardial injury with subsequent necrosis, where conditions other than coronary contribute to the imbalance between myocardial oxygen supply or demand. The myocardial …