Heartfelt Focus – Dr. Quesada’s Story
If you had troublesome, recurring chest pain what would you think? Heart problems, right? Let’s say further evaluation revealed some damage to the heart because a specific muscle protein level – troponin - was high, but other testing showed no large vessel blockage or obstruction, and therefore were told no further treatment was necessary.
Sound plausible? This scenario is possible, but not acceptable, according to Odayme Quesada, MD, who created and leads the new Women’s Heart Center at The Christ Hospital The Christ Hospital | Women’s Heart Center.
“What can happen in many of these situations is that, while there is no significant blockage in the large vessels, there is disease of the microvascular system-the small heart vessels-- that can go undetected and untreated,” according to Dr. Quesada. “This phenomenon occurs more frequently in women.”
While Dr. Quesada speaks to the fact that heart disease is the most common cause of death for men and women alike, it is much less understood in women, and often presents differently in women, and some heart disease are more common in women. For example, another area with unanswered questions is the relationship between hypertensive disorders of pregnancy (high blood pressure in pregnancy) including preeclampsia, and subsequent patient risk of heart disease– as much as eight times higher risk. Her recommended prevention for these patients includes adhering to Life’s Simple 7 (https://www.heart.org/) to decrease cardiovascular disease and also have regular checkups to assess for the development of heart disease early, such as hypertension.
“Essentially, the reason we are behind on medical research in women’s heart disease is because heart disease was thought to be a man’s disease; however, it’s as much a woman’s disease as it is a man’s disease,” Dr. Quesada shares. “One in four women die of heart disease. Women with heart disease have worse outcomes than men. Because it was historically considered a man’s disease, it was primarily studied in men, and why we have so many unanswered questions for women.”
Dr. Quesada is so passionate about filling the void of knowledge needed for standardized treatments, she is dedicating all her cardiovascular research on women. She is managing several concurrent projects, including a significant $1M study funded by the National Institute of Health. This aspect of her work involves studying the relationship of hypertensive disorders of pregnancy mentioned earlier. While studies already exist which link hypertensive disorders of pregnancy (high blood pressure) with increased risk of heart disease, there are many unanswered questions on why this happens.
“What led me to this career path was a serendipitous opportunity during my medical school at Yale, where I first participated in a research project in pregnant women. Later, during residency at UCSF (University of California at San Francisco) I led a pilot study on the hemodynamic changes in women during pregnancy. I became intrigued in the stark difference in the cardiovascular hemodynamics of women with pregnancies complicated by preeclampsia and normal pregnancies. I also became aware of the increased risk of cardiovascular disease in women who have pregnancies complicated by preeclampsia and realized that we don’t have a great understanding of what causes this.
“This led me to Cedars (Cedars-Sanai Smidt Heart Institute in Los Angeles) because I wanted to be mentored by the world-renowned cardiologist, Dr. Noel Bairey Merz, director of the Barbra Streisand Women’s Heart Center at Cedars. “I further specialized in women’s heart disease both clinically and in research. I had known I wanted to be a physician since I was in high school, and it was this journey that brought me to women’s cardiovascular subspecialty.”
Dr. Quesada shares it was the first female medical director of the National Institutes of Health, Bernadine Healey, MD, (appointed in 1991) who initiated the Women’s Health Initiative, which ultimately came to life with funding in the amount of $625 M. From her efforts, the medical world began focusing on research in women.
“My goal with research is to advance our knowledge of cardiovascular disease in women so we can better diagnose and treat our patients,” Dr. Quesada shares. “Our team is committed to exceptional care and raising awareness about cardiovascular disease in women. As one of the only female-focused cardiovascular disease programs in the nation, The Women’s Heart Center is a groundbreaking new approach to cardiovascular care. Our team is proud to bring such a vitally important program to the region.”
If you or a woman you know is experiencing heart symptoms, call The Women’s Heart Center at 513-585-2140. In addition to receiving the care or second opinion needed, you may be eligible for inclusion in Dr. Quesada’s research. You can find more information on the WHC website at: The Christ Hospital | Women’s Heart Center
Women’s Heart Center programs and services
The Christ Hospital Women's Heart Center cares for many aspects of female-focused cardiovascular needs, including:
Heart conditions that require specialized knowledge of the disease process in women
Pregnancy-related heart health, including pregnancy complicated by a heart condition or high blood pressure and risk assessment for cardiovascular disease after delivery.
Prevention for women at high risk of developing heart disease
Cardio-oncology for women with cancer or going through cancer treatments that affect heart health
The Christ Hospital also offers advanced diagnostic procedures such as coronary reactivity testing and advanced cardiac imaging testing.
Many conditions increase a woman's risk for developing heart and vascular disease. Our experts recognize this and provide specialized care for heart problems related to:
Pregnancy disorders, such as preeclampsia and gestational diabetes
Early menopause
Autoimmune diseases, such as lupus
Second opinions
Our experts provide second opinions, which can be especially important for cardiovascular diseases that predominantly affect women, including:
Myocardial ischemia with no obstructive coronary artery disease (INOCA)
Myocardial infarction with no obstructive coronary artery disease (MINOCA)
Coronary microvascular dysfunction (CMD)
Coronary artery vasospasm
Takotsubo cardiomyopathy (stress cardiomyopathy, or broken heart syndrome)
Spontaneous coronary artery dissection (SCAD)
Hypertensive disorders of pregnancy, such as preeclampsia, gestational hypertension, eclampsia