Cornell Women's Heart Director on Improving Detection of Aortic Aneurysms

Bloomberg

Watch Cornell Women's Heart Director on Improving Detection of Aortic Aneurysms - Bloomberg on Dailymotion

Transcript

00:00When it comes to heart disease, whether it's men or women, it's such a big problem here in the U.S.,

00:05the number one killer and cause of death for both men and women. What is it? Our diet, lack of

00:10exercise, all of the above? What? Absolutely. And you have to think about other things as well.

00:15You know, you pointed out really nicely that young individuals can also be affected. And I think it

00:20goes to show that we really need to know a lot of things about our health. We really need to know

00:24our numbers. We need to know what our blood pressure is early. We need to know what our

00:27cholesterol is. We need to know what our blood sugar is. And certainly young people may have

00:31other genetic conditions. And it's important to know what those genetic conditions are.

00:35So you're focusing on something called an aorta aneurysm. I've heard of brain aneurysms.

00:40What is an aorta aneurysm? It's a great question. You know, the aorta very recently, just in 2024,

00:46was it's identified as its own organ and very rightly and deservedly so. So it's the largest

00:50artery of our body. It attaches to the heart. It's actually shaped like a candy cane and it takes blood,

00:55it pumps blood that's pumped from the heart and it actually transfers it all the way to all the

00:59organs of our body, the head, the neck, the heart itself, the liver, the intestines, the spleen,

01:04the kidney, the leg. So it's critical for our sustenance so much so that there are physicians

01:09such as myself, cardiologists, surgeons that really dedicate their lives in caring for individuals who

01:15have problems with the aorta. And one of those problems is an aneurysm. And an aneurysm is

01:21essentially a dilation or bulging of that aortic wall. And so it's a little bit distinct from brain

01:26aneurysm in terms of its location, but there are individuals with aortic aneurysms that can have

01:31brain aneurysms and vice versa. So you've got actually an NIH funded study that you are doing.

01:37Tell us a little bit about that. Yeah, absolutely. And nice to hear that you're getting money and

01:42continue to get money from the NIH. Thank you. We actually recently got it. So I'm very,

01:46very grateful for such a milestone. You know, when individuals have aneurysms, once they really

01:51increase in size, dangerous complications can occur. And what do I mean by that? You know,

01:56you think of a balloon as it gets bigger and bigger, a balloon can burst the aorta. As it gets

01:59bigger and bigger, you can have a tear in the aorta. So now we have life saving procedures,

02:04aortic surgery that can be pursued to prevent these complications that occur. I think it goes with

02:09the theme. We want to be proactive rather than reactive. And so what our grant looks at is it combines

02:15imaging, advanced imaging and genetics to really figure out how individuals with aortic conditions

02:21do through time, especially those who've had that aortic surgery. So, I mean, I'm just hearing about

02:27this for the first time, aorta aneurysm. Are there symptoms? Is it the kind of situation where you

02:32don't know it until it happens? Because I know some of the brain aneurysms can happen in a snap.

02:37Yeah, absolutely. Yes, it is. I mean, you can have large aortic aneurysms and you may not know that

02:42you have one until something catastrophic occurs. I think there is a positive outlook on aspects of

02:49this. Now provider awareness is going up. Now we're doing imaging for unrelated reasons. People are

02:54getting scans for prevention-based readings. Now we're taking very intricate family histories. Yeah,

03:00you were going to say something. Well, we're talking with Dr. Nupur Narula. She's director of the

03:03Women's Heart Program at Weill Cornell Medicine. It was so funny. I'm trying to think who did a story,

03:07whether it was the Times, whether it was us. But it was just this idea. If you go to, is it Korea?

03:13You can get scan head to toe every year. What a brilliant idea. I don't know if our insurance

03:19companies would like that very much. Well, that's it. And it's a lot less expensive,

03:22but it's such a great preventative kind of way to go about it. And of like any kind of early

03:27problems that are out there. Why aren't we doing it? Is it just because it's so expensive here in the

03:31U.S.? It's expensive. And so I think that there's... And why is it so expensive? Because if we were all

03:36getting it, the frequency, I don't know. It's a really good question. I think the more we scan,

03:41the more we find. You can find things that may not matter, but we'll go down roads of testing.

03:46Right. Right. So I think that it goes to highlight a couple of things. Family histories, taking them

03:50from our family is free, right? Ask your family, have they had any sort of issues with the aorta? Has the

03:56aortic size been measured? Have they had any sort of prevention test? Did the aortic size come up in that

04:00test? Did anybody die suddenly in the family? If they did, was an autopsy done? You know,

04:05you can ask several questions to figure out what the cause of the passing was. So these are ways to

04:10screen. And then I always say, participate in research studies if you have the ability to do

04:14so, because I think involvement in studies and women's involvement in studies is really,

04:19really critical. That's a really good point. And you know, sometimes you go to the doctor. I've

04:21been asked you, would you like to participate? I think the first instinct says, no, no, no, no,

04:25thank you. But it really can help science overall in general for years to come.

04:29Absolutely. And the more science we do, the more sex specific, college, but that's because I got

04:33paid. And some studies will still pay actually, you know, depending on what you do. But I think

04:39the participating in this allows us to also come up with sex specific differences that have, you know,

04:45impact on behavior. Well, let's go. Yeah, let's go another layer down because you specifically are

04:50focusing too on pregnant women. Yes. Why? So I think pregnancy is a very delicate time in our lives,

04:57right? There's several changes that happen. Your heart rate changes. It goes up. The blood

05:00pressure goes down initially, but in the later stages of pregnancy, your blood pressure rises,

05:05including after pregnancy, the cardiac output, the pump, the efficiency of our heart goes up because

05:10we're supplying blood to ourself, but also the placenta. And then you have all the hormonal changes

05:14that occur, estrogen, progesterone, and these can actually change the microstructure of the wall.

05:19So if you think of women who already have underlying aneurysms, and then you add in all of these

05:24changes, these women are in a more vulnerable state. So I think understanding what they have,

05:29their condition, instituting appropriate surveillance, and thereby appropriate management

05:35allows us to take women through pregnancy safely. Your advice to maybe a pregnant woman hearing this

05:40or someone who has a pregnant person in their life and they want to be proactive. What's your advice

05:44to them? Know your numbers. Really know your numbers. Know all of your numbers. We very rightly talk

05:49about blood pressure, cholesterol, blood sugar. You should also know if you've had a scan, what

05:54is the aortic size? And also know your family history. Two big things to take away. We always

05:58need to be proactive rather than reactive in as many ways as we can. Is it more likely for a pregnant

06:03woman to have an aortic aneurysm? So it's not that the pregnancy will cause the aneurysm. It's that

06:10a woman may have an aneurysm and during pregnancy, it is possible that that aneurysm may grow a little bit

06:16in size. Okay. I also, before we let you go, uh, I was reading an article recently in the times

06:21about the signs of a heart attack and they're not always the outward, Oh, I'm holding my chest,

06:26you know, shortness of breath. And there was one doctor who did some research in India

06:30who was saying, you know, it could, if you look at blood pressure through the years,

06:34if your blood pressure seems to oscillate a lot, that could be a signal. Is that true?

06:39You know, I mean, I think, listen, I think anybody can have any sort of manifestation,

06:44right? So when you even think about blood pressure, in what environment are we measuring

06:47our blood pressure? Is it at home? Is it in the doctor's office? So certainly, you know,

06:51there are changes in blood pressure, changes in heart rate, and then there are symptoms,

06:55but there can be atypical symptoms, not the classic symptoms that we see. And so I think

06:59if anything feels unusual, bring that to your provider. That's your time to really talk about it.

07:04Oh, okay.

Category

Transcript

Be the first to comment

Recommended