The Women’s Heart and Vascular Center at Mount Sinai Fuster Heart Hospital in 2023 launched two clinics for Mount Sinai patients who are at high risk of heart disease due to pregnancy-related complications and to breast cancer treatment—a risk that many patients and physicians may not be aware of. “These two areas are very important opportunities to evaluate women at risk for developing cardiovascular disease, educate women, and promote their well-being,” says Roxana Mehran, MD, founding Director of the Women’s Heart and Vascular Center.
“We continue to expand our services by providing a full risk assessment, diagnostic testing, and counseling to women of all ages through our specialized clinics,” says Dr. Mehran, Professor of Medicine (Cardiology), and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai. “We expect these clinics to be among our busiest, because there are so many women actively looking for and truly in need of these services. Not all physicians are aware of or pay attention to these underdiagnosed risk factors, which is why we perform a full cardiovascular health evaluation for every woman that we see in our clinics.”
So far, most referrals to the clinics are within the Mount Sinai Health System, and a major source is the Dubin Breast Center of The Tisch Cancer Institute. Chemotherapeutic agents and radiation therapy can increase cancer patients’ cardiovascular risk, by adversely affecting heart and vascular tissue. “Certain chemotherapies are associated with risk of heart disease, either immediately or later on in life,” says Birgit Vogel, MD, Associate Director of Interventional Cardiovascular Research and Clinical Trials at Icahn Mount Sinai, who sees patients along with Dr. Mehran. The center works closely and collaboratively with Amy Tiersten, MD, and all physicians at the Dubin Breast Center. “We feel fortunate to have the opportunity to evaluate these women for cardiovascular disease,” Dr. Mehran says.
The center also works closely with the Cardio-Oncology Program at Mount Sinai under the direction of Gagan Sahni, MD, Professor of Medicine (Cardiology), who for the past ten years has treated cardiologic conditions associated with cancer treatment.
“These two areas are very important opportunities to evaluate women at risk for developing cardiovascular disease, educate women, and promote their well-being.”
Roxana Mehran, MD
Of equal concern to specialists at the Women’s Heart and Vascular Center are women who have experienced pregnancy-related issues such as premature delivery (before the 37th week of pregnancy), gestational diabetes, preeclampsia, or low birth weight of a child. The Center collaborates with the Maternal-Fetal Medicine team in the Department of Obstetrics, Gynecology and Reproductive Science to offer a full evaluation of other cardiovascular risk factors and close follow-up to prevent heart disease in women with such history.
Preventive care strongly undergirds the work of both cardiac clinics, and that means taking into account risk factors that cardiologists seldom ask their female patients about, such as stress, anxiety, or domestic violence. “Women are really surprised at how much time we spend gathering their full history,” Dr. Vogel says. “We explain to them that there are many under-recognized factors that increasing clinical evidence has shown to be associated with heart disease later on in life.”
That comprehensive evaluation is often followed by advanced testing, such as coronary calcium scoring, which can detect heart disease at its earliest stages and provide valuable guidance to physicians on how aggressively to manage cardiovascular risk factors. In addition to their own expertise, Drs. Mehran and Vogel draw on Mount Sinai’s vast network of specialists and resources, including endocrinologists, nutritionists, mental health support, and social workers.
Dr. Mehran, a renowned clinician, interventional cardiologist, and researcher, is devoted to women’s cardiovascular health and helping women advance in the field of cardiology. She is Chair of The Lancet Women and Cardiovascular Disease Commission, whose members from 11 countries in 2021 released the first-ever global report and recommendations for decreasing the burden of cardiovascular disease in women. Dr. Vogel was lead author of the report.
“The commission is the first of its kind to ignite a global awareness of sex- and gender-related disparities in cardiovascular disease,” says Dr. Mehran, “and we’re building on its findings to inform the treatment and cutting-edge research taking shape at Mount Sinai through the Women’s Heart and Vascular Center at Mount Sinai Fuster Heart Hospital.”
For more information, call 212-241-8000 or email womensheartandvascularcenter@mountsinai.org.