Heart research that echoes around the world
Her first research project was considered lethal for her patients. But they all survived and the results resounded around the world. Since then, cardiac specialist Professor Eva Swahn has reaped success, one after the other. Now she’s at the threshold of becoming a representative for all of Europe’s cardiologists.
It was early in the 1980s that Swahn first set foot in Linköping University Hospital, at that time Linköping Regional Hospital.
“I received a good foundation as a clinician in Jönköping, where I did the first part of my specialist medical training. But as a constantly inquisitive, curious person, I missed all the arguments you could get at a university hospital.”
The thought of being a researcher had never crossed her mind. However Professor Lars Wallentin, now at Uppsala University, was looking for a doctoral student for a study of patients with mild or impending heart attacks.
“We were going to test an early work sample on the patients, which at the time ran counter to the recommendations – it was actually believed to be fatal!”
For two years, Swahn put 400 patients on the EKG test cycle to find out which of them had a residual lack of oxygen in their coronary vessels. Those who had no changes were allowed to go home but which treatment should the remainder receive?
“We decided to try a small dose of acetylsalicylic acid, another world first. Since then we’ve tested different strategies for both large and small heart attacks, and had great successes.”
While analysing the early work sample, Swahn discovered that it couldn’t predict the seriousness of the illness in the same way for women as for men.
This finding sparked an interest in studying the differences between genders regarding diagnostics, risk assessment, and treatment of cardiovascular disease; later it expanded to kidney function and the tendency to haemorrhage.
“Our register study showed that women do not receive as much medicine, and not the same medicine, as men. They also don’t receive balloon dilatation as often as men. I don’t think they’re treated worse, just differently,” Swahn says.
She’s still quite alone in studying gender differences in cardiac care, and is careful about taking political advantage of the results. When the Swedish TV series “About a heart” (Om ett hjärta) was shown in 2008, she protested in a debate article alongside other cardiologists about the oversimplified picture presented.
“It’s unbelievable that SVT would broadcast a series like that without checking the facts whatsoever!” (SVT is a Swedish public broadcasting company)
Rather than just looking at the differences between the sexes, she wants to get closer to individual factors that affect the course of the illness and opportunities for treatment, for example socioeconomics and genetics. Sweden is especially adapted to such studies, thanks to our unique registries, especially the last four digits of our social security numbers. The comprehensive heart registry Swedeheart (formerly Riks-HIA) has its origins in Linköping, where a regional HIA register was started back in 1984.
“An enormous goldmine that researchers in other countries look on with a jealous eye.”
Identifying information is removed from the register however the studies, like all other medical research, mean difficult ethical considerations. Swahn is involved in the issues through organisations like Linköping Academic Research Centre (LARC), the university and county council clinical research support unit, where researchers get advice on the voluminous regulations as well as statistics, keeping records, and more.
In parallel with her research, she also devotes a lot of time and energy to the clinic. She draws no line between research and clinical work. The combination is productive, but also unpredictable.
“The cardiology clinic is a fantastic place to work. I was on the way to both Karolinska Institutet and Södersjukhuset (Stockholm South General Hospital) in Stockholm, yet both times I chose to stay in Linköping.” One strength is that the boundaries between institutions and departments are not that large.
Aside from her daily job, Swahn has been President of the Swedish Society of Cardiology and the Swedish Heart Association (Svenska Hjärtförbundet) and now another prestigious assignment is on the horizon. She is one of three nominated to the post as President-elect of the European Society of Cardioloy (ESC), where she is currently one of the vice-presidents; she is responsible for communications and media issues.
ESC, with its headquarters in the European Heart House above Antibes in the French Riviera, has members in 54 countries and is a major authority in cardiac care. The person chosen will be President-elect for two years, then President for two years, and finally “Past President” for two years.
In this case, it would be a powerful ending to a career that could have gone in an entirely different direction.
“I’d never thought about being a doctor; I started with chemistry instead but my sister, who was studying at Karolinska Institutet, convinced me to apply there. I’ve never regretted it,” Swahn says.
However she does have a weakness for architecture, something that finds an outlet on her family estate on Gotland, Sweden's largest island in the Baltic Sea. There she designed and built a boatman’s cottage on her own and she enjoys the peace and quiet there for a few weeks every summer.
But she’s not a native Gotlander; her accent shows she’s more at home in the Stockholm district.
“I was born in Vaxholm to Finnish parents, and spent my first seven years in Hasseludden on Värmdö. My father was an engineer but wanted to be a farmer; he studied a few agricultural courses at Hermods and bought an estate on Gotland. I lived there throughout my school years.”
Now a house near the River Stångån in Linköping is her permanent address, along with Göran Stenberg, her husband since 1999.
The river Stångån, Gotland, and the Riviera: Eva Swahn is quite satisfied with her place in the world.
06 FEB 2012
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Image showing a massive heart infarction in the front left ventricular wall. The heart is pictured from the side in an MRI scanner, and arrows indicate the infarcted area. In the video below you can see that the heart wall does not move in this area. The picture is taken from a study at CMIV at LiU.
Last updated: Wed Mar 14 11:53:30 CET 2012