Women’s Heart Disease

Heart disease is the leading killer of women in the United States, yet it often is under-recognized and under-treated. We recognize the importance of preventing, identifying and treating women with cardiovascular disease.

The approach in the Center for Women’s Heart Disease is comprehensive and multi-disciplinary, addressing the unique needs of women at all stages of their life. The center employs a coordinated multidisciplinary approach including cardiologists specializing in maternal heart disease, maternal-fetal medicine experts, anesthesiologists and pulmonologists.

Our team

Our multidisciplinary team of expert physicians and nurses includes:

Cardiology

• Kathryn Lindley, Director (Cardiologist)

• Homaa Ahmad, MD (Cardiac Imaging Specialist)
• Anita Bhandiwad, MD (Cardiologist)
• Angela Brown, MD (Hypertension Specialist)
• Sharon Cresci, MD (Cardiologist)
• Lisa de las Fuentes, MD, MS (Cardiologist)
• Marye Gleva, MD (Cardiac Electrophysiologist)
• Becky Menley, RN (Cardiovascular Nurse)
• Linda Peterson, MD (Cardiologist)
• Nishath Quader, MD (Cardiac Imaging Specialist)
• Marc Sintek, MD (Interventional Cardiologist)
• Amanda Verma, MD (Advanced Heart Failure Specialist)
• Kathleen Zhang, MD (Cardio-oncologist)

Surgery

• Puja Kachroo, MD, MS (Cardiothoracic Surgeon)
• Kunal Kotkar, MD (Cardiothoracic Surgeon)
• Marc Moon, MD (Cardiothoracic Surgeon)
• Nanette Reed, MD (Vascular Surgeon)

https://cardiothoracicsurgery.wustl.edu

https://vascularsurgery.wustl.edu/

Obstetrics and Gynecology

• Michael Dombrowski, MD (Maternal-Fetal Medicine Specialist) – Clinical Liaison
• Jeannie Kelly, MD, MS (Maternal-Fetal Medicine Specialist) – Clinical Liaison
• Tessa Madden, MD, MPH (Family Planning Specialist)
• Nandini Raghuraman, MD, MS (Maternal-Fetal Medicine Specialist) – Research Liaison
• Gillian Schivone, MD, MS (Family Planning Specialist)
• Danielle Turnbull, WHNP, BSN (MY HEART Clinic)

https://obgyn.wustl.edu/divisions/maternal-fetal-medicine-ultrasound-division/

https://obgyn.wustl.edu/divisions/family-planning-division/

Anesthesiology

• Amber Benhardt, MD (Obstetric Anesthesiologist)

• Arvind Palanisamy, MD (Obstetric Anesthesiologist)

https://anesthesiology.wustl.edu/patient-care/obstetrical-anesthesia/

Pulmonology

• Murali Chakinala, MD (Pulmonary Hypertension Specialist)
• Colleen McEvoy, MD (Pulmonary Hypertension Specialist)

https://pulmonary.wustl.edu/patient-care/pulmonary-vascular-service/

Neonatology

• Jagruti Anadkat, MD (Newborn Medicine)

https://pediatrics.wustl.edu/newborn

Clinical expertise

Women’s Heart Disease Management

• Comprehensive cardiovascular care for women living with heart disease, including cardiomyopathy, coronary artery disease, valvular heart disease, congenital heart disease and arrhythmias
• Expert management of cardiac conditions disproportionately affecting women, such as coronary artery dissection (SCAD), heart failure with preserved ejection fraction, Takotsubo cardiomyopathy, coronary vasospasm, and microvascular heart disease
• Counseling regarding hormone replacement therapy in women with heart disease
• Prevention and treatment of cardiovascular disease associated with cancer and cancer therapy
• Advanced surgical therapies for coronary artery disease in women, including off-pump coronary artery bypass surgery, minimally invasive coronary artery bypass grafting, and arterial revascularization.
• Treatment of complex aortic diseases, including chronic dissection, thoracic aortic aneurysms, and thoracoabdominal dissections and aneurysms.
• State of the art treatment of valvular heart disease, including transcatheter aortic replacement, mitral valve repair, and right anterior thoracotomy surgical aortic valve replacement.
• Medical and surgical treatment of atrial fibrillation

Multidisciplinary Maternal Cardiovascular Management Team

• Pregnancy risk assessment, planning, and management for women with pre-existing conditions including congenital heart disease, coronary artery disease, cardiomyopathy, valvular heart disease, aortopathy, and arrhythmia
• Management of cardiovascular complications of pregnancy including peripartum cardiomyopathy, pre-eclampsia, and coronary artery dissection
• Co-management with primary obstetrician and cardiologist or assumption of patient care, as per patient and referring physician preferences

Multidisciplinary Family Planning Clinic

• Contraception counseling for women with pre-existing cardiovascular conditions such as cardiomyopathy, congenital heart disease, pulmonary hypertension, arrhythmias, coronary artery disease and valvular heart disease
• Providing safe and effective methods of contraception, individualized to each patient’s unique cardiovascular and pregnancy risk profile
• Counseling regarding medication teratogenicity, contraceptive safety and effectiveness, and cardiovascular risk of pregnancy

Preventative Heart Health

• Cardiovascular risk assessment and risk factor modification to reduce the incidence of cardiovascular disease in women
• Expert management of difficult-to-control or resistant hypertension
• Recognition of cardiovascular risk factors disproportionately affecting women, including pregnancy complications (such as preeclampsia, gestational diabetes, and fetal growth restriction) and autoimmune disease
• Lifestyle modification through individualized nutrition counseling and supervised exercise therapy

Postpartum Heart Health

• Multidisciplinary blood pressure management, cardiovascular risk factor screening, contraception provision, and health counseling through the MY HEART postpartum hypertension clinic

Clinical affiliations

The center is supported by a network of collaborative services, including:

• Maternal-Fetal Medicine
• Center for Adult Congenital Heart Disease
• Gynecology and Family Planning
• Pulmonary Hypertension
• Perinatal Behavioral Health Service
• Hypertension Clinic
• Center for Heart Rhythm Disorders
• Cardio-Oncology
• Cardiothoracic Surgery
• Vascular Surgery

 Ongoing Clinical Research

The Center for Women’s Heart Disease is committed to advancing care in women through clinical research.  The following clinical studies are ongoing through our center:

• iSCAD Registry – A multi-centered registry to improve patient diagnosis and outcomes following Spontaneous Coronary Artery Dissection (SCAD)

• • Site Principle Investigator: Kathryn Lindley, MD
  • Learn more: https://iscadregistry.bidmc.org/index.php

• Pregnancy Associated Cardiovascular Outcomes Registry – Cardiovascular phenotyping registry for pregnant women with cardiac disease, including preeclampsia. Participants will undergo cardiac imaging and will have blood collected.

• • Principle Investigator: Kathryn Lindley, MD
• MY HEART (Maternal hYpertension clinic to improve postpartum Health, Educate, And Reduce long-Term complications) – A post-partum multidisciplinary clinic for women with hypertensive disorders of pregnancy, aimed at reducing short- and long-term complications of high blood pressure in pregnancy.
  • Principle Investigator: Kathryn Lindley, MD

• SURVIVE Registry – Multi-center clinical registry for patients with cancer and cardiovascular disease.
  • Site Co-investigator: Kathleen Zhang, MD
• ACE-MOVE registry – Registry enrolling patients with suspected or confirmed diagnosis of cardiac amyloidosis.
  • Site Co-investigator: Kathleen Zhang, MD
• ACE-Detect – Prospective multicenter study evaluating performance and safety of the ASSURE Wearable Cardioverter Defibrillator
  • Site Co-investigator: Marye Gleva, MD
• ADAPT Response: Randomized trial of a specific ICD algorithm in patients with biventricular ICD devices
  • Site Co-investigator: Marye Gleva, MD
• Post-approval registry of the subcutaneous ICD
  • Site Co-investigator: Marye Gleva, MD
• INIX-HF Study: evaluating the effects of inorganic nitrate on exercise performance in patients with heart failure
  • Principle Investigator: Linda Peterson, MD
• SPYRAL Trial: Study investigating renal denervation for patients with uncontrolled hypertension.
  • Site Principle Investigator: Angela Brown, MD