Let’s Talk About Women And Cardiology

Did you know that the national average for women providers represented in cardiology is only 6%? At Centra's Heart and Vascular Institute, our female providers more than double that average number. Listen in as Dr. Eve Chongthammakun describes what being a female cardiologist looks like day to day and why this month is so important to highlight women's heart health.

Note: Due to extra social distancing and masks being worn during recording for the safety of all parties, some audio may sound more muffled than normal.

Speaker 1:

Thanks for joining us for this episode of Centra Script‪s, where we talk health and wellness and practical tips for your everyday life. And now here's your host, Kate Kolb.

Kate Kolb:

Well, welcome to another episode of Centra Script‪s. My name is Kate, and I'm happy to be here with you today. This is actually our second installment of the Heart Month podcast that we're doing to help highlight some of the really great work that's going on with our cardiologists here at Centra and some of our amazing providers. And speaking of an amazing provider, I am joined by Dr. Eve Chongthammakun today. And let's just be honest, I absolutely was scared that I was going to slaughter your last name. So that might be the only time that I mentioned it in this and we're just going to call you Dr. Eve from now on.

Dr. Eve Chongthammakun:

You're doing a fantastic job. Thank you so much.

Kate Kolb:

Thank you. Well, it's such a pleasure to have you here today, and we're going to be talking a little bit about women in cardiology and the heart month in general and what that looks like. But I want to give the listeners an opportunity to get to know you a little bit now. So if you don't mind, if you can just tell us a little bit about your background and where you came from and what brought you to Centra.

Dr. Eve Chongthammakun:

Sure. So my name is Dr. Eve Chongthammakun, originally I am from Thailand, so I did an MD PhD program back home in Thailand, and then I completed internal medicine residency at Cleveland Clinic in Ohio. And then I went on to do my cardiology fellowship in Miami, at University of Miami, Jackson Memorial Hospital. And then, because of my passion in adult congenital heart disease, I did an advanced fellowship in adult congenital heart disease at the Medical College of Wisconsin. And then here I am at Centra.

Kate Kolb:

So you've been all over the place.

Dr. Eve Chongthammakun:

I have, yes.

Kate Kolb:

That's great. So how long have you been at Centra now then?

Dr. Eve Chongthammakun:

It's been close to six months now.

Kate Kolb:

Okay. So brand new, kind of, in our rounds of providers here, but already hearing lots of just really amazing things about your practice and your patients. Well, first of all, let's talk about what your position is currently here at Centra. What do you do here?

Dr. Eve Chongthammakun:

Sure. So I'm a cardiologist at Centra, as you know, and I'm specialized in adult congenital heart disease. And aside from that, my other specialized areas in cardiology are cardio obstetrics. So I take care of a lot of women, pregnant women with heart conditions and also sports cardiology. So, all these fields, definitely highly involved in women's heart health. And I guess that's like a focus today. Aside from that I am also specialized in cardiac imaging. So I do a lot of advanced cardiac imaging, like CTs and MRIs.

Kate Kolb:

Very cool. Well for our listeners who might not understand maybe all the terminology, what does the word congenital really mean when you talk about it in terms of cardiology?

Dr. Eve Chongthammakun:

Absolutely. So in terms of cardiology, so we have multiple different fields. Most of the cardiac disease that we understand would be the acquired heart disease, like heart attacks, blockages, and things like that, or heart failure, but for the congenital heart disease patients, they were born with congenital heart disease. So they were born with a heart condition and because of that, they require multiple repairs, multiple surgeries and intervention throughout their lifetime.

Kate Kolb:

Gotcha. Okay. So that's kind of more of that following the patient through a lot of stages of life.

Dr. Eve Chongthammakun:

Exactly. Exactly.

Kate Kolb:

Yeah. Well, let's talk a little bit too. I wanted to talk to you specifically, like I mentioned before, this is our second podcast that we're doing in honor of heart month. And before we kind of even get into the topic of women specifically in cardiology, I want to talk about this. I talked about it with Dr. Hoyt and Corrin, but I want to get your insights too of why do we talk about heart month? Why is that something important and why should we be passionate about that?

Dr. Eve Chongthammakun:

Absolutely. Because aside from congenital heart disease where patients were born with heart conditions, majority of heart conditions are preventable. So, the February of every year is the heart month and this is a time where we should focus and highlight, raise the awareness of heart disease. And given that the majority of heart conditions are preventable and this is probably when we should definitely start taking care of our heart health. Also talk to people around us, the people that we love, that they should also take care of their heart health as well.

Kate Kolb:

So it's an awareness. We want to make sure that every year we're thinking a high level about this and making sure that people understand, hey, you should be paying attention to your body, paying attention to your heart. Great. Well, before we go a lot further, I would love to know what prompted you to pick cardiology as your specialty in the medical field? What was your calling in that?

Dr. Eve Chongthammakun:

Well, I believe that the heart is the most important organ in the body, of course. But aside from that, I grew up in a family of healthcare providers. So over time, like growing up and when I started going to the medical school, I learned that cardiology is one of the very few fields in medicine where interventions actually work and can actually save patients and save lives. Whether it's preventative strategies to prevent the development of heart disease from the beginning, or whether it's medical therapy treating with medication therapy or even like all the way to catheter based intervention or surgical intervention. And I feel like that actually makes a difference in the patient's lives.

Kate Kolb:

So you really felt called to it because you felt like it was an area of medicine that you could distinctly make a difference.

Dr. Eve Chongthammakun:

Absolutely.

Kate Kolb:

Yeah. So I we'll talk a little bit more about this as we get into this, but there are not many female providers, nationally speaking, even internationally speaking maybe, but in this field. And so was that something that you just were naturally drawn to, or did you have a mentor that kind of pointed you in that direction at all?

Dr. Eve Chongthammakun:

I'm going to be honest with you, I think I knew that I love cardiology and this was something that I've always wanted to do. And because there are very few women in cardiology and I remember in fellowship, so I was one of the two female cardiology fellows among a total of 25 cardiology fellows. So I feel like it is very important that we need more women in cardiology and so far we're very supportive of each other. And I absolutely think that this is something that women can do and I will totally support anyone who's interested.

Kate Kolb:

That's amazing. Well, as we move in through the rest of our topics here about this, we did want to really highlight some of these statistics about women in cardiology. And we want to kind of focus in this first point on kind of the patient and caregiver focus. And so our 0.1 here we're going to talk through, I want to talk with you specifically about women and the concerns for heart health and issues that may come up. So what are some of these CDC's stats, and that's the Center's for Disease Control stats on patients concerns. Everybody I think has probably heard the line, well, heart disease is the number one killer of women. But I don't know that many people actually, maybe they don't believe it, or maybe they don't really wrap their brain around that. But talk a little bit about some of these statistics for why it's so concerning for women to be concerned about these heart diseases.

Dr. Eve Chongthammakun:

Absolutely. So, heart disease remains the leading cause of death in both men and women in the United States. So it's actually not breast cancer or lung cancer. So death from heart disease is more than death from breast and lung cancer combined. And especially in women, about one in every five female deaths can be attributed to heart disease. And this is why it's very important that we have to focus on women's heart health.

Kate Kolb:

And that's a really high percentage if you think about it, because I mean, one in five, that's that's 20%. That's a huge number when you think about all the deaths that are occurring and that takes into account everything. So the fact that that's one in five women being affected by that is huge. Talk a little bit about then, demographic of these women. What types of race, age, that sort of thing. What types of people need to be concerned with this?

Dr. Eve Chongthammakun:

Yeah, so particularly the African American and Caucasian women. So these are the number one. Heart disease is the leading cause for these groups of female patients. And even for the other ethnicities, American Indian, Alaskan native women, both heart disease and cancer are roughly the same number, cause the same number of deaths each year. And for the other ethnicities, Hispanics and Asian or Pacific Islander women, heart disease is the second cause of death, just second to cancer.

Kate Kolb:

Yeah. So it's definitely not a respecter of persons or ethnicity or anything like that. It is definitely something that we need to be concerned about. So, even age brackets were surprising to me when I was looking up some of these statistics because I read from the CDC that about 1 in 16 women age 20 and older have coronary heart disease. And I think for a lot of us who, even our listeners or even just people that... I've been around the hospital now for five and a half years, while I've been here. I grew up in a medical home. My dad was a provider. So I've been around medical terminology my whole life but I think it surprised me when I started reading some of these statistics about how young some of these patients are with heart disease. Now your specialty in congenital heart disease, I'm sure that that makes up for some of those numbers. But in terms of some of these more acute episodes that we see in women, that really is not something where it will just affect 60 and older or anything like that, right?

Dr. Eve Chongthammakun:

Right. So yeah, absolutely. The risk for heart disease go up with age, of course, but we have to take into consideration there could be congenital anomalies of the coronary arteries or a patient's had certain conditions, Kawasaki disease, anything in their childhood that definitely put them at increased risk for developing coronary artery disease at an early age.

Kate Kolb:

So what are maybe some of the things that patients who would be concerned about this need to look out for either as a very young child, what would be the things that parents could look out for in somebody that might be predisposed to this? And then alternatively, what are things that people need to look out, women in particular, as they start to age?

Dr. Eve Chongthammakun:

Yeah. So risk factors are important. So there's family history of premature heart attacks or sudden cardiac death. That is something that we definitely should take into consideration. High blood pressure, diabetes, any history of vascular disease. So these are all important risk factors. Elevated cholesterol. And aside from that, women also have different presentations compared to their men counterparts. So women can have atypical presentations for a heart attack. For example, instead of having chest tightness or just over chest pain, they could develop as indigestion or shortness of breath. And because of the atypical presentations in women, that could delay the diagnosis and management. And this is why we would like to raise awareness that women's heart health is important and we'd like all the women to understand the risk factors, understand their possible presentations, their symptoms that could lead to the diagnosis of heart disease.

Kate Kolb:

So talk a little bit about those symptoms then just a little bit more because as a woman, I think at least for me in my life, I'm a single mom with three kids and life is busy and I work a full-time job and I'm trying to keep up with everybody too. I think some of those things that you just mentioned, like shortness of breath or indigestion, those are not necessarily things that I would red flag in my mind and think, oh, there might be something wrong. So how do you know when a symptom has gotten to the point where you need to get something checked out?

Dr. Eve Chongthammakun:

So number one, as a cardiologist, you would have to have high suspicion, especially in women who have risk factors for heart disease. So they present with atypical symptoms, heart disease would have to be on the differential and then you just have to think of it. Also, I always encourage patients to stay active, increase their physical activity, exercise regularly. Just so that they know that, oh, hey, I usually I'm able to walk up four flights of stairs for example, or I could maybe walk or run two miles a day and then all of a sudden I'm gradually feeling that, oh, I'm becoming more short of breath walking one mile or maybe walking up one flight of stairs as opposed to four flights previously. So this is also a concern.

Kate Kolb:

Okay. So that makes sense. So it's monitoring those symptoms. So it might be something, for some of these people that are like, well, I get short of breath every time I walk up the stairs, but if it's something where it's changed maybe the nuance of how you feel okay, then that's really super important. The other thing that I wanted to ask you about in terms of signs and symptoms is, is there a longevity of how long you should pay attention to this? Is there a timeframe where it's been okay, I'm having these symptoms for two weeks or I'm having these symptoms for three months. When would somebody need to call their provider and say, "Hey, I think something might not be right here?"

Dr. Eve Chongthammakun:

Oh, if it's an acute presentation, that's something that would be a red flag. That would definitely trigger further investigations and management immediately. .

Kate Kolb:

And would they call their primary care provider first for a referral, or can you self refer for cardiology problems?

Dr. Eve Chongthammakun:

They can do both. So I would say we have really good, Centra has really good primary care practices and we're in close contact and we touch base all the time for our patients. So if there's any concern at all coming from the primary care providers then we're happy to see the patients immediately or as an urgent visit. And the patients can also self-refer to see us in clinic as well.

Kate Kolb:

Okay. And then going forward into this then, so women who have been diagnosed with some sort of heart event, or maybe ongoing heart disease and that sort of thing. I talked a little bit about this with Dr. Hoyt and [inaudible 00:15:43] in our previous podcast too about, we are really working here at Centra to try to partner with people to live their best lives. And so women who have been diagnosed with these events or disease going forward, what would your recommendations be to someone who's living with heart disease and how do you overcome that? And then what does that best life look like going forward for them?

Dr. Eve Chongthammakun:

So I think with our advanced technologies and medical therapy, I think women with heart disease who are living with heart disease now, they can live a pretty much normal life and normal longevity. And as long as they take good care of themselves, take good care of their hearts, remain healthy and adhere to heart healthy lifestyle and minimize the risk factors and follow up regularly. And I think this is something that we have been able to make sure that they can live a good life and they can do what they want to do.

Kate Kolb:

That's awesome. I think the prognosis has changed so much in even just recent years, but the last couple of decades, too, that people are seeing that ability. If you were diagnosed with something, it's not an end of life sentence by any means at all. So that's great. So to kind of move into this, the secondary topic that I wanted to talk to you about, we mentioned a little earlier, a few minutes ago that there are not, historically speaking, that many women providers in the field of cardiology. And you mentioned you were one of two fellows in your class that were going through this. So statistically speaking, and this was from average data that had been pulled just within this past year from, I think the American Heart Association and a couple of other, American Academy of cardiology, overall there's 91% male cardiologists and 9% female cardio cardiologists as a national average for this field.

Dr. Eve Chongthammakun:

Shocking, right?

Kate Kolb:

Yeah. That so surprised to me. But here, and I think the reason it surprised me is because I've been around Centra long enough now to know that we have much more than that in our percentages here at our Stroobants practice and the Heart and Vascular Institute. So, we pulled our numbers, and here at HVI we currently have 31 cardiologists, six of whom are female, which makes our percentage 81% male and 19% female. That's a huge number. That's just amazing. And can you talk a little bit about what that's like to be in a practice where those numbers are so much greater than the national average?

Dr. Eve Chongthammakun:

Yeah. No, I am very proud to say that at Centra here, we have a relatively large number of female cardiologists within the group, which is actually more than double when compared to the national statistics. And I think the support's been great, even among us female cardiologists here at Centra, we've been able to support each other and we work well together. And we also receive great support from our male colleagues as well. And as I mentioned, it's very important to me that I continue to support my female colleagues. And it's not just the female cardiologists here that we have at Stroobants, we also have a strong team of female APPs and that's a really large team. And I just want to shout out to them that our female APPs are fantastic and our job at Centra just cannot be accomplished without these women in the field of cardiology.

Kate Kolb:

And so to define APP for those who might not understand, that is...

Dr. Eve Chongthammakun:

So they are the advanced-

Kate Kolb:

I think it's advanced practice providers. All these acronyms, it sometimes feels like the military when you work in the healthcare field. So yeah, it's kind of funny. So those would be nurse practitioners and PAs and different things like physician assistants and things like that. So yeah, you're absolutely right. The team is incredibly strong here. How do you feel that that has helped the patient populace for HVI and how you guys are able to serve the community here to have that kind of spread between male and female presentation?

Dr. Eve Chongthammakun:

Yeah, no, I think you need a good balance for everything. And nowadays, historically men used to have a lot more heart disease than women, but then nowadays, given with the lifestyle, with the environment and everything, genetics and all of that. So women are having heart disease too and it's great to be able to connect to our female patients and to be able to understand them, what they're going through. Understand their struggle living with heart disease and what their needs are. Say if they're younger, if they have a heart disease, would they be able to become pregnant and raise their child, carry to term and things like that. And I think these are all very important points that I feel like I'm able to help out with the community.

Kate Kolb:

That's awesome. And do you feel like you see, I mean, clearly you can't give your information on your patients, but do you feel like you see a pretty good blend of male and female patients and that you're able to kind of have that rapport?

Dr. Eve Chongthammakun:

Oh, yes, yes. I would say that there are a lot of female patients there within our practice.

Kate Kolb:

Yeah. And that's awesome to kind of have the female patients have the option to see either a male provider or a female provider in that too. So I want to talk a little bit about for anybody that's listening, you and I were on a call a couple of weeks ago about women in cardiology in general and what that looks like for the practice of cardiology on a national level and what we can do to kind of help spur the interest of that on. So what would you say to a young girl or a young woman who is really interested in the medical field and just doesn't know which direction that they would want to go, what would you inspire them with for cardiology?

Dr. Eve Chongthammakun:

Yes, absolutely. So yeah, as you mentioned, this is something that me, Centra and the American College of Cardiology, we're working on the women in cardiology events in order to support young girls, college students, high school students who are maybe interested in pursuing cardiology as a career in the future. So again, I can't emphasize enough that we really need more women in the cardiology field. And I would really like to encourage all the young women out there who are interested in medicine to consider going into cardiology. So previously there used to be a belief that cardiology is a very competitive, very stressful field, and only men can do it and that the work-life balance may not be the best for female individuals. At this point I really just want to say that within the field of cardiology, there are many [inaudible 00:23:10] fields and such as preventive cardiology, cardiac imaging. So these are absolutely interesting field and they also offer excellent work-life balance for any female cardiologists out there. So again, I think any young girls, I give full support for that.

Kate Kolb:

I'm glad that you brought up that work balance piece because I think in some of my research as I was preparing for this podcast and to come in and talk to you, that was one of the key indicators that I kept seeing in article after article, after article, on reasonings why there are not as many women in cardiology and a lot of it's cited that, well, I can't have both a family and a career if I go into cardiology. I can't be present with my family if I already have a family if I go into cardiology. And so what you just said speaks volumes to the fact that there are so many subcategories of cardiology that would still allow you to work in that field, but have that balance. And so have you found that to be true in your life?

Dr. Eve Chongthammakun:

Yes. So yeah, I have a great work-life balance. So I still have my free time, I get to do my hobbies. So I'm very active, so very outdoorsy. So I do a lot of outdoor activities. I still get to go skiing, snorkeling, things like that. Exercising on a daily basis. A lot of my female cardiologists friends, they're mothers, they're happily married, they're still able to care for their kids and still they are very successful being cardiologists as well.

Kate Kolb:

And I think that overall in the medical field, we're starting to see more and more of those advances happening in some of these more classically male dominated fields of study. And so it's exciting to me to see so many more female providers that are coming across in multiple different areas, but especially here with HBI. I think the fact that you guys are, like you mentioned just a few minutes ago, double the amount, actually just over double the amount of the national average for female representation. That's huge. And that says a lot about the rapport here and the culture here, and I just applaud you guys for that and the good work that you guys are doing here.

Dr. Eve Chongthammakun:

Thank you. Yes. I think we're a great team.

Kate Kolb:

Yeah. Very inspiring for sure. And so as we're kind of wrapping up here with this episode, I have one more question because I was talking to my daughter about these podcasts and things that we were planning the other day and she said, "Well, can you ask her what her favorite part about being a heart doctor is?" So if you had to answer an 11 year old little girl of what your favorite part is about what you do, what would you say?

Dr. Eve Chongthammakun:

Oh my God, to an 11 year old. If it's really coming from me I would probably say, I love the physiology of the heart, but quite honestly, again, I just love seeing patients getting better. It's so rewarding to see them come back in and they say, "Oh my God, whatever you did, you just saved my life." And that's probably the best thing that I get from being a cardiologist.

Kate Kolb:

That's awesome. And because you work in congenital too, you probably get to see many of those moments as you follow some of these patients for a long time.

Dr. Eve Chongthammakun:

Yes. It's very interesting to see them right from when they're a teenager and I'm hoping to follow them all the way until they're in their nineties.

Kate Kolb:

Yeah. That's amazing. I love that outlook and I love your heart behind what you do, no pun intended, is so large for the patients that you care for and the practice here at Centra. So, anything else that you would just be remiss if we didn't close out this thing today with?

Dr. Eve Chongthammakun:

No, I just want to say it's been great being here at Centra and since we're focusing on women's heart health and women in cardiology today, I just want to say please look forward to our more work podcasts videos in order to promote women's heart health and women in cardiology. That will be coming out soon.

Kate Kolb:

Yeah, for sure. And Dr. Eve is exactly right. We're going to be focusing and showcasing some of those things throughout the rest of this month with heart month and on our social channels. And of course you can always check out that content at centrascripts.com or centrahealth.com as well, to look up those different things. And actually, we have a whole dedicated page currently right now with all of our heart month information at centrahealth.com/heart. So definitely feel free to check that out. Dr. Eve, it's been such a pleasure to have you here today and to talk to you.

Dr. Eve Chongthammakun:

Thank you so much, it's been a pleasure to be here.

Kate Kolb:

Yeah, it's been fun. It's so good to meet more of our providers and be able to put those faces with those names. And so we just thank you for hanging out with us today.

Dr. Eve Chongthammakun:

Thank you so much.

Kate Kolb:

Awesome. And for our listeners out there, thank you for tuning in today. And again, go check out all our information on those websites that we mentioned or our social channels. You can just search Centra or Centra Health and we will pop up on those channels for you. So take care and we'll talk to you next time.