Harmony R. Reynolds, MD

My research focuses on less common heart disease syndromes that predominantly affect women, particularly heart attack and chest pain with open (unblocked) arteries, including takotsubo syndrome (also known as broken-heart syndrome).

Myocardial infarctions (heart attacks) are typically the result of cholesterol plaque that narrows or blocks the flow of blood. However, in a condition referred to as myocardial infarction with nonobstructive coronary arteries (MINOCA), which affects as many as 20 percent of patients who have experienced a heart attack and is particularly common among women, angiography reveals that plaque blockages alone cannot explain the heart attack.

Answering the question of what other factor, or factors, might be responsible is the purpose of my current four-year research study. The project, which is funded by a grant from the American Heart Association, follows 125 women in the United States and Canada and is one of the first studies dedicated to women to use the advanced imaging technology of optical coherence tomography (OCT), which enables our team to take images from the inside of arteries. We will compare and contrast images captured through optical coherence tomography (OCT) with images captured using MRI —which visualize the areas of the heart muscle that have been damaged—to determine whether MINOCA is caused by a break in a cholesterol plaque or blood vessel wall inside the artery and which parts of the heart are affected.

Right now, physicians are not sure how to treat patients with MINOCA; it’s not clear what diagnostic tests or medications are best. By revealing the likely causes of MINOCA, our study will help physicians make treatment and prevention choices for their patients and set the stage for future studies to test specific treatments.

My interest in MINOCA began early in my career; as an NYU School of Medicine cardiology fellow completing a rotation on the coronary care unit at NYC Health + Hospitals/Bellevue, I saw many women who experienced heart attacks even though their arteries weren’t blocked, and I was driven to find out why.

With funding from the National Institutes of Health, my team is also studying chest pain with open arteries. This American Heart Association program also includes a study to examine whether mindfulness exercises and other relaxation techniques can help manage stress in patients with heart conditions, with the help of NYU Langone collaborators.

With the help of NYU Langone collaborators, we are working to understand better how platelets—the cells that form blood clots—differ from individual to individual, and whether these variations play an important role in a given woman’s risk for a heart attack.