Advice for Women's Heart Health

Podcast Transcript

Announcer:

Welcome to Love Your Heart, brought to you by Cleveland Clinic's Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute. These podcasts will help you learn more about your heart, thoracic and vascular systems, ways to stay healthy and information about diseases and treatment options. Enjoy.

Leslie Cho, MD:

Welcome everyone to a session on Ask Your Heart Doctor. Today our focus is on women and heart disease and we're joined by our surgeon as well as our cardiologist colleagues. And we're going to go around and introduce ourselves first. My name is Leslie Cho. I'm the director of Women's Cardiovascular Center at the Cleveland Clinic.

Donna Kimmaliardjuk, MD, FRCSC:

I'm Dr. Donna Kimmaliardjuk, and I'm a cardiac surgeon with a special interest and focus on coronary artery disease and bypass grafting.

Christine Jellis, MD, PhD, MBA:

I'm Christine Jellis. I'm an imaging cardiologist with a special interest in advanced imaging. I'm one of the detectives and we use this imaging to figure out how bad heart disease is.

Leslie Cho, MD:

There are plenty of patients who cannot come to Cleveland Clinic. And so there's many questions on our chat about how do we find the best place for our heart disease. If we feel like we're not being heard, how do we go about trying to find the right doctor? What kind of advice can we give to our patients who are not within our area?

Christine Jellis, MD, PhD, MBA:

I think it's a great question. I think we all want to be heard. And I think particularly as women, we sometimes have unusual symptoms or our symptoms are minimized and sometimes frankly, our voices are not heard in the way that they should. So I think it's really important to get a good sense of who your local providers are. And hopefully all of you have good local providers. A good primary care doc is often the first place to start. They know the cardiologists and heart surgeons in their area.

I think these days, most large hospital systems have their data on the website, so certainly we do here at Cleveland Clinic. You can look at outcomes, look at the number of surgeries. You want to make sure a center is a high-volume, excellent center with really good outcomes, so you can be rest assured that you're in the right hands. And then Leslie, I want to give a shout-out to you because you've really spearheaded our Women and Cardiovascular Center, and that has been a phenomenal advantage to a lot of women coming to Cleveland Clinic and other centers around the country whereby women's needs are addressed more specifically. And you may want to speak on that. I'm not doing it justice.

Leslie Cho, MD:

Oh, thank you. I mean, I think for our patients, what I tell them is that oftentimes if you can't come to the Cleveland Clinic, you want to find centers of excellence. Outcomes are out there. But for many women who can't come to the Cleveland Clinic, there are women's cardiovascular centers around the country. But I really am very passionate about this notion of centers. And I think centers create synergy among physicians. It also creates research. It's a great area for expertise to develop and for people to have a niche practice that can really help our women. For years and years and years, women who are going for aortic valve surgery, they were more likely to have patient mismatch because they were smaller. They had small annular size, and now we know from TAVR that women do better with TAVR because of the small annular size. And I think those kind of important advances come about because a place like this where we can study a large number of women.

So I'm going to sort of ask you guys to think about a couple of things, some of the pearls of wisdom that you can give to our patients. And I'm going to start first. And I think the number one message I want to get across is heart disease is 100% preventable. Even if you have the worst family history, you can still lower your risk for heart disease. And the way to do that is to not smoke, to get regular checkups, get your cholesterol tested, your blood pressure tested, make sure you are within a reasonable range and not diabetic. And it's really important, especially if you're a woman, to be mindful about some of your other risk factors.

Gestational diabetes is a big risk factor. If you've had preeclampsia or if you've had hypertension during pregnancy, it’s incredibly important to see someone and to start on that journey for risk factor modification. If you have PCOS, if you have autoimmune disease, it's again, very important to get your risk factors sorted out so that you don't need to see Donna in the future or me in the future. And I think for women, I know that there are many of you that feel sometimes unheard, but if you are able to get in a different chat groups with other patients, or if you find your way to us, we have a wonderful website where people can actually ask questions with our nurses. We'll be happy to get in touch with you. Donna?

Donna Kimmaliardjuk, MD, FRCSC:

Yes. No, that's a great message. And one message that I like to always put out there is, again, to advocate for yourself and hopefully find a care provider that you are comfortable with and that listens to you. And there is evidence to show that patients have better outcomes with heart disease and heart attacks and heart surgery when treated by a female cardiologist and a female surgeon. And especially in terms of the surgery world and heart disease or coronary disease, women do very well with certain specialty operations that I offer here.

So for example, beating heart surgery, women disproportionately do very well with that, use of radial arteries for bypass grafts or use of both mammary arteries for bypasses that women tend to get less of historically in studies and across North America. And so advocate for yourself, find a center of excellence where we are going to really try to treat you with the best evidence and best therapies that we have to date to give you the best long-term outcome. And so that would be my message. And I always say to my patients, I say, it's important to me that you trust me and feel comfortable with me. And I would never be offended if you aren't, but find yourself a doctor that you trust and you're comfortable and happy with.

Leslie Cho, MD:

Christine.

Christine Jellis, MD, PhD, MBA:

I think to add to that, we're so blessed that we have more wonderful young women going into the fields of cardiology, vascular medicine, cardiac surgery, vascular surgery, thoracic surgery. The numbers are rising exponentially, and I think that's great for us as a specialty, but also for our patients. And thanks, Donna, for highlighting because the data does show that women provide exceptional care. So I think my advice is be proactive. I think as women, we often minimize our symptoms. There's often other things that we're juggling, whether that's work, family commitments, looking after elderly relatives and small children. Sometimes it's difficult to carve out time for ourselves. And so I think if you know something's not right or you're just starting to notice that you are having shortness of breath or you're slowing down, or you just need help with weight loss or preventative strategies, reach out to your primary care doc.

Have them send you to a cardiologist if it turns out that there is something more significant going on and be proactive about that. Because I think one of the messages that we hope we've shown is that it's better to be aware of these things early so we can monitor you and then get the timing of intervention right, rather than be chasing your tail after the fact when someone has already got long-term damage to their heart. Or unfortunately, sometimes we see people presenting when they're already really sick. So be proactive and what we want to do is see outcomes in women be great so that we can all grow old together.

Leslie Cho, MD:

Yes. Well, thank you so much for joining us today, and we look forward to seeing you again in the future.

Announcer:

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