National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Comprehensive Australian Clinical Guideline for Diagnosing and Managing Acute Coronary Syndromes 2025

Scope:
This guideline makes recommendations for:
assessing adults aged 18 years and older with suspected ACS
managing confirmed ACS
recovery after ACS and secondary prevention of future vascular events.

The definition of myocardial infarction (MI) has been refined from the Fourth universal definition of myocardial infarction to align more closely with the clinical syndromes that characterise occlusive and non-occlusive MI. This guideline adopts the term acute coronary occlusion myocardial infarction which includes both atherosclerotic and non-atherosclerotic causes.

The guideline predominantly focuses on managing people with MI due to atherosclerotic plaque rupture, ulceration, fissure, or erosion. Some recommendations presented in this guideline may be relevant to other types of MI (e.g. type 2MI), particularly with respect to initial acute treatment and post-hospital care. Specific recommendations are presented in some cases for MI due to non-atherosclerotic causes (e.g. spontaneous coronary artery dissection [SCAD]) (Figure 1).The guideline does not cover management of non-ACS presentations and non-cardiac chest pain. It does not include detailed guidance on managing related clinical conditions, such as heart failure, or comorbidities such as cancer or diabetes. Healthcare professionals should refer to existing guidance, where available.