NYC Health + Hospitals/Elmhurst, the largest public hospital in the New York City borough of Queens, opened the Women’s Heart Health Institute in February.
The hospital’s cardiology department serves about 7,000 patients annually, 30% of whom are women, according to a Feb. 11 news release from the health system.
Gayatri Setia, MD, director of preventive cardiology, and Rosy Thachil, MD, director of the hospital’s cardiac intensive care unit, shared what drove NYC Health + Hospitals/Elmhurst to open the institute.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What prompted the launch of the Women’s Cardiovascular Institute at Elmhurst?
Dr. Gayatri Setia: The three of us — [Deborah Reynolds, MD, associate director of NYC Health + Hospitals/Elmhurst’s cardiology department], Dr. Thachil and I — each came to our desire to improve women’s heart health in our own journeys. Personally, in the clinic setting, I have heard far too many times from my female patients that they feel historically dismissed and overlooked by the healthcare system to the point where they do not even attempt to seek care. Instead, they just tolerate a worse quality of life.
Dr. Thachil, who is on the critical care side, will point out that women are also far less likely to receive appropriate care in an emergency, such as a cardiac arrest, because of simple things such as CPR training only using male practice models. Dr. Reynolds has long had a passion for improving imaging evaluation of women to reduce radiation exposure, which can have implications for pregnancy and long-term cancer risk, and improve detection for “nontraditional” heart disease.
Many times women get half-answers for their heart problems because we simply don’t have the right tools to diagnose them, and one of our goals for the Women’s Cardiovascular Institute is to help develop those tools.
Q: How will the institute work toward addressing disparities in women’s cardiovascular care that may differ from traditional approaches?
GS: Two ways mainly, which feel basic but are still hard to find at times. The first is having providers who are invested in listening to women and their concerns, who can take into account all the unique factors that affect women disproportionately.
For instance, understanding how pregnancy and hormonal therapy (such as for contraception or for menopausal symptoms) can affect a woman’s heart health or how familial obligations can provide obstacles in caring about one’s health. Medical conditions that disproportionately affect women, such as autoimmune diseases and breast cancer, also have unique impacts on the heart.
The second way is time. We purposely give our providers enough time to actively explore symptoms and educate women on their cardiovascular health.
Q: When it comes to the conversation about women’s cardiovascular health, what do you believe needs to change? How is the institute working toward shifting that conversation?
Dr. Rosy Thachil: For too long, women’s cardiovascular health has been sidelined — both in clinical practice and research. The narrative has often centered around the “typical” symptoms and risk profiles, which were largely derived from cardiovascular studies in men. This has led to missed or misdiagnoses, under-treatment and a persistent myth that heart disease is a “man’s disease.” That needs to change.
We’re hoping to rewrite that narrative. We’re focusing on personalized, inclusive care. We’re also educating patients and clinicians about the unique presentations and risk factors women face — from pregnancy-related conditions to the effects of stress and social determinants of health.
Q: How do you envision the Women’s Heart Health Institute shaping broader changes in cardiovascular care?
RT: We envision the institute as a hub for all of the above. Within the hospital system, we hope to embed women’s cardiovascular health into routine care, improving referral pathways and developing multidisciplinary models that bring together cardiologists, OB-GYNs, primary care physicians and other specialists. We are also committed to advancing research that reflects and serves the unique needs of our diverse Queens population. And finally, beyond the walls of the hospital or clinic, we hope to empower the women in the community with knowledge — raising awareness about their risk factors, recognizing early signs and symptoms and providing the tools they need for education, advocacy and prevention.
