This Women’s History Month, Let’s Make More Women’s Histories Possible

Even as a medical student, I knew I wanted to become a cardiologist. During my fellowship, I discovered electrophysiology, and my attendings at Northwestern, Richard Kehoe, MD, and Terry Zheutlin, MD, truly made me excited about the field. They taught me how to take care of patients with compassion, care, and innovation: at the time we were just learning how to do catheter ablations and implant cardiac defibrillators while researching the best way to prevent sudden cardiac death in patients with ventricular arrhythmias.

But the basics of diagnostics mattered, too. I remember being shocked when a young woman from an affluent neighborhood in Chicago came to me after suffering for a year with palpitations. She had been told that her symptoms were most likely due to stress and anxiety and not to worry about them too much. I did an electrocardiogram—which, to my utter surprise, had never been done before—and it showed an accessory pathway. She, in fact, had Wolff-Parkinson-White syndrome, which in 1990 was potentially curable with a catheter ablation. Having performed the first radiofrequency ablation in Chicago at Rush University Medical Center, I found her accessory pathway and easily ablated it. She has lived a meaningful life without further cardiovascular symptoms for over 30 years.

A few years after I took care of that patient, the American Heart Association (AHA) in Chicago asked me to help spread the word about cardiovascular disease mortality in women. At the time, very few cardiologists were paying attention to the widening gap in CVD mortality between women and men. Remembering how my patient had been unjustly misdiagnosed, dismissed, and mistreated, I knew I could make a difference. My education at an all-girls school from grade school to college helped prepare me for this opportunity: I know a thing or two about listening to women’s concerns. I had found my passion.

In 2003, I co-founded the Rush Heart Center for Women and, ever since, have been committed to helping with the AHA’s efforts to increase awareness about heart disease in women. Since its inception in 2004, I have been a member of the executive leadership of the Chicago AHA Go Red for Women, raising funds and doing community activities. I wear red every day to draw attention to the Go Red campaign and participate in community events to teach women and men about heart-healthy lifestyles to prevent heart disease.

Let’s take a moment to celebrate the history of progress in women’s cardiovascular care. Over the last few decades, we’ve learned a huge amount about sex differences in CVD, especially in atrial fibrillation and other arrhythmias. My colleagues and I have established the evidence base for dedicated heart centers for women and how these can improve outcomes. We’ve published on the interactions between breast cancer and CVD, and efforts were made to reduce the cardiac complications of cancer therapy in women. Collaborating with other specialists, such as cardio-cognitive neurologist Neelum Aggarwal, MD, we’ve detailed the important connection between CVD and cognitive impairment. We have a better handle on the importance of physical activity in improving cardiovascular outcomes in African-American women, and—with “brain games”—shown how to achieve gains in cognitive function. We’ve made headway on dietary screening and CV health, as well as the creation of community-based programs and support networks to help our female patients and their families adopt healthier lifestyles and adhere to long-term behavior changes.

Despite all this progress, too many female patients are still suffering from anxiety over their heart disease due to a lack of a definitive diagnosis, and the lack of a doctor who takes the time to listen. Too many are not being referred to centers that can help them. Many don’t have adequate insurance to pay for life-saving medications: some drugs aren’t covered, or co-pays are too high. Other women face significant challenges stemming from entrenched social determinants of health, even seemingly simple things like access to the types of food and environments that facilitate a healthy lifestyle.

For Women’s History Month, I’m looking back but also looking to the future—future patients, but also future cardiologists. I want younger cardiologists and students who have not yet considered cardiology to imagine a life full of confidence, a career as meaningful as my own, one full of compassion for their patients as well as happiness in their personal lives. These days there are plenty of resources for them to “learn” cardiology, but there is a scarcity of mentors who can model both academic and life success. Hopefully, by sharing my life’s journey—my history—future generations of cardiologists, both women and men, will be drawn to a career as rich in potential for innovation and personalized care. 

In 2023, we celebrated the 20th anniversary of the Rush Heart Center for Women. Though I have stepped down as the center’s medical director, I know I will always be connected with and continue our work. I have gained a life of purpose. In return, I know my commitment and that of many others has helped countless women with or at risk of heart disease go on to lead lives of their own: they’ve gained the chance to leave their own mark on history.

Off Script is a first-person blog written by leading voices in the field of cardiology. It does not reflect the editorial position of TCTMD.