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Broken heart syndrome

The research group of Per Tornvall has investigated the phenomenon of myocardial infarction with normal coronary arteries for more than 10 years now. The research programme include both diagnostics and treatment as well as mechanistic studies. The latter with focus on genetic factors studies by genome-wide association studies.

Investigation, mechanisms and treatment of myocardial infarction with normal coronary arteries

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The number of patients fulfilling the diagnostic criteria of myocardial infarction with angiographically normal coronary arteries is larger than previously thought. Six to eight per cent of all patients with myocardial infarction have no stenoses of their coronary arteries. Furthermore, up to one third of all women with myocardial infarction lack stenoses on coronary angiography. The great majority of all patients have Takotsubo stress cardiomyopathy also called “broken heart syndrome”. Other common diagnoses include myocarditis and “true” myocardial infarction of unknown cause. The diagnostic work-up, including a magnetic resonance imaging investigation, is of great importance.


Vulnerability to sympathetic stress does not persist in takotsubo stress cardiomyopathy.
Collste O, Alam M, Sundqvist M, Olson J, Wardell J, Tornvall P, et al
J. Card. Fail. 2014 Dec;20(12):968-72

No myocardial vulnerability to mental stress in Takotsubo stress cardiomyopathy.
Collste O, Tornvall P, Sundin Ö, Alam M, Frick M
PLoS ONE 2014 ;9(4):e93697

Coronary plaque burden, as determined by cardiac computed tomography, in patients with myocardial infarction and angiographically normal coronary arteries compared to healthy volunteers: a prospective multicenter observational study.
Brolin EB, Jernberg T, Brismar TB, Daniel M, Henareh L, Ripsweden J, et al
PLoS ONE 2014 ;9(6):e99783

Risk factors for myocardial infarction with normal coronary arteries and myocarditis compared with myocardial infarction with coronary artery stenosis.
Agewall S, Daniel M, Eurenius L, Ekenbäck C, Skeppholm M, Malmqvist K, et al
Angiology 2012 Oct;63(7):500-3

Myocardial infarction with normal coronary arteries is common and associated with normal findings on cardiovascular magnetic resonance imaging: results from the Stockholm Myocardial Infarction with Normal Coronaries study.
Collste O, Sörensson P, Frick M, Agewall S, Daniel M, Henareh L, et al
J. Intern. Med. 2013 Feb;273(2):189-96