As part of our âMeet Yale Internal Medicineâ series, today’s featured physician is Meghana Rao Brito, MD, Assistant Professor of Clinical Medicine (Cardiovascular Medicine).
An interest in medicine began early for Meghana Rao Brito, MD. âIt sounds a bit clichÃ©, but I really became fascinated by the world of medicine while hovering around my dad, an emergency room doctor. I would sit next to him when he had dinner late at night and listen to the stories he told my mother, both shocked and intrigued. The decision to study medicine was second nature to her, but entering a specialty was more difficult. âEach area is fascinating in its own way. But in cardiology, we really diagnose and solve problems, and have the ability to change a patient’s quality of life. It is not only medicine that she loves, she appreciates the lasting relationships that she develops with her patients and their families. “In cardiology, you bridge the gap between intensive care and outpatient medicine in a truly unique way.”
During his university training in Rhode Island, Rao Brito developed an interest in cardiovascular imaging, in particular the influence of 3D echocardiography on the management of structural heart disease. âAdvances in imaging technology have truly enabled a personalized approach to the management and treatment of valve disease. The idea of ââpersonalized medicine is the one that Rao Brito tries to defend throughout his practice. More recently, she has been interested in the disparities that exist in cardiovascular care for women.
âCardiovascular disease remains the leading cause of death among women in the United States and Europe,â says Rao Brito. âAnd despite significant advances in the field and an overall decrease in cardiovascular mortality overall, that number has leveled off in women. There are several reasons for this – there are clear gender differences in the pathophysiology of cardiovascular disease and yet women have not been adequately represented in large clinical trials in the past. She goes on to explain that often women tend to present late and are more likely to ignore their symptoms. âThere is often an underlying fear that their symptoms may not be taken seriously because of the stereotype of the ‘hysterical young woman’. We need to raise awareness among doctors and the rest of the medical community. “
Another interesting aspect of cardiovascular care for women is that their entire risk profile is affected by their ability to have children. For example, women who develop gestational disease or preeclampsia during pregnancy have a four times higher risk of developing hypertension.
âThere are many aspects to being a woman that increase your risk for cardiovascular disease. And if that’s not targeted, if someone isn’t looking at these pieces, it’s easy to slip through the cracks. This leads to patients who are sicker overall because you have allowed multiple co-morbidities to develop. “
To address these issues, Rao Brito is working with his mentor, Lisa Freed, MD, FACC, Assistant Professor of Medicine (Cardiovascular Medicine) to provide a multidisciplinary approach to heart and vascular disease in women. She recently started seeing patients at a new location in the Yale Women’s Heart and Vascular Program in Uncasville, Connecticut, where she will work with primary care physicians and local obstetricians to provide personalized care to women. Community outreach has been invaluable to her both in educating women about their risk of cardiovascular disease, as well as reaching out to primary care physicians and other specialists to make them aware that this model of care is available. âAs physicians, it’s up to us to step into these small pockets of communities and build trust. “
In addition to his general cardiology practice and women’s cardiac and vascular practice, Rao Brito finds variety by working with fellows in the Echocardiography Lab at Yale New Haven Hospital and providing cardiology advisory services to Electric Boat through to a partnership between Electric Boat and Yale New Haven Health. âWorking in a variety of clinical settings makes this profession interesting and fun. ”
Going forward, Rao Brito hopes to continue to develop a multidisciplinary women’s health initiative with the support of the Yale New Haven health system. âI feel really lucky to have the opportunity to take on the challenges that cardiovascular care for women has presented. I believe that personalized, multidisciplinary medicine provides the most comprehensive care and I am delighted to be able to provide it to our patient population.