234. Narratives in Cardiology: Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero – Minnesota Chapter

In this episode, Daniel Ambinder and Amit Goyal (CardioNerds co-founders), Dr. Gurleen Kaur (medicine resident at Brigham and Women’s Hospital and Director of CardioNerds Internship), student doctor Adriana Mares (medical student at the University of Texas El Paso/Texas Tech University Health Sciences Center El Paso, CardioNerds Academy Intern), and Dr. Teodora Donisan (general cardiology fellow at the Mayo Clinic and CardioNerds Academy Chief) discuss with Dr. Mayra Guerrero (Interventional Cardiologist and Professor of Medicine at the Mayo Clinic) about challenges with diagnosing and treating valve disease in women, as well as ideas on how to increase recruitment for women in cardiology including interventional and structural cardiology. Dr. Guerrero shares her inspiring personal journey and advice for how to navigate becoming a structural cardiologist as an international medical graduate, woman, and mother. Audio editing by CardioNerds Academy Intern, student doctor Adriana Mares. The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza. Video Version • Notes • Production Team The PA-ACC & CardioNerds Narratives in Cardiology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Video version - Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero https://youtu.be/KvKADqUwUHQ Quoatables - Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero “Work hard, give it your best, and your work will speak for itself. Don’t be afraid to work hard and you’ll be able to achieve anything you want.”“I’m very fortunate to have had the opportunities that I’ve had, but now it’s my responsibility and the responsibility of many to make sure that we create those opportunities and that we provide mentorship for others who may want to follow the same steps into this field.”“I get angry, it’s normal to have emotions, but what I’ve learned is to transform my anger into something good – think of a project, find a paper, do something good for your career…channel that energy to do something good.”“It’s important that even at young ages you start thinking about how to pay it forward.”“Don’t wait too long to have kids. There’s never a perfect time to be a parent. Once you decide to have a family don’t put a pause on your personal life for your career.” Notes - Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero Notes (by Dr. Teodora Donisan) Structural valve disease in women and valve care in the global settingHeart disease is the leading cause of death for women. However, the awareness regarding this major public health concern has been declining over the past decade. Valve disease awareness is one of the lowest, at less than 3%.Women have higher mortality than men when they undergo surgical aortic or mitral interventions, mainly because of a higher risk profile. For example, women with severe aortic stenosis usually present at older ages and have many associated comorbidities, however the outcomes are good when they are treated with transcatheter aortic valve replacement (TAVR). Despite this, women are less likely to be referred for aortic valve replacement (AVR) than men. Once women are referred for therapy, they are more likely to be treated with TAVR than surgical aortic valve replacement (SAVR).There is a deficiency in trial enrollment for women which we need to address in order to generate the knowledge we require with regards to treatment. We also need to identify whether there are referral biases when it comes to AVR.Another hypothesis for the disparities in valve disease treatment for women when compared with men might be the decreased number of women in cardiology, especially in interventional cardiology (<10% of interventional cardiologists are women). Of note, <3% of TAVR operators are women (1.5% are surgeons and 1.5% are interventional cardiologists). Diversity and inclusion in interventional cardiologyAbout 8% of interventional cardiologists are women and only 4.2% of cardiologists are Latinx.In order to increase recruitment for WIC, the problem needs to be addressed on multiple levels.Mentorship should be provided to cardiology fellows, and they should be supported in their choice for interventional cardiology. This should be equally offered and tailored to women and underrepresented minorities. Support should be given even earlier in their careers and lives, at school and even with the education they receive at home. Career goals can be achieved with hard work and determination, and this should be an integral part of the education and upbringing from an early age.There is an institutional responsibility to help address this problem. It can start with training to decrease unconscious bias, improvements in workplace conditions (e.g., schedule flexibility, provide maternity/paternity leave, lactation rooms), opening leadership opportunities for women and URiMs, establishing diversity and inclusion committees.The FDA, industry, and societies should have DE&I committees to ensure inclusive representation in clinical trial leadership and to ensure recruitment of women and minorities.Work life harmony as an interventional cardiologistYou must choose your life partner well, caring for your family is teamwork.You might miss moments, but if you work together with your partner and children, it works out.It’s important to provide a strong role model for your family. References Vogel B, Acevedo M, Appelman Y, et al. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. Lancet. 2021;397(10292):2385-2438. Production Team Dr. Gurleen Kaur Amit Goyal, MD Daniel Ambinder, MD