Heart attack despite having healthy coronary arteries
Myocardial infarction in people with healthy coronary arteries is far more common than once thought. Much remains unknown about the causes, diagnosis and treatment of these infarctions, but Per Tornvall, Professor of Cardiology at the Department of Clinical Research and Education, Södersjukhuset hopes to put this right.
Myocardial infarction, commonly known as a heart attack, is not always caused by a narrowing of the coronary artery. Professor Tornvall researches on people who have suffered a heart attack despite having healthy coronary arteries, a patient group that has only recently been found to be relatively large, representing around 10 per cent of all infarctions, or 2,000 to 3,000 cases a year in Sweden.
“One of the objectives of our research is to develop diagnostics in the field, so that all these patients can be correctly diagnosed,” says Professor Tornvall. “My research group has already shown how diagnostics can be improved using magnetic resonance (MR), and we are now following this up with a study in which we hope to be able to make the correct diagnosis in 70 per cent of cases solely on the basis of MR. A correct diagnosis is important, as different types of infarction require different types of treatment.”
The most common cause of myocardial infarction in the presence of a healthy coronary artery is a so-called “broken heart”, or takotsubo as it is known to medicine, where much of the left ventricle ceases to work and swells up. Professor Tornvall’s group is studying the causes of broken heart syndrome and the risks it entails.
“We know that it’s associated with stress, but what the underlying mechanisms look like we’ve yet to find out. We’ve also recently begun a study of its genetic causes in an attempt to discover if there are any differences in stress hormone receptors.”
Treatment of this type of infarction is another aspect of the work being done by Professor Tornvall, who is also preparing a national treatment study in the field.
Text: Anders Nilsson, first published in "From Cell to Society" 2015. Translation: Neil Betteridge.