As part of our “Meet Yale Internal Medicine” series, today’s featured physician is Meghana Rao Brito, MD, assistant professor of clinical medicine (cardiovascular medicine).
An interest in medicine started early for Meghana Rao Brito, MD. “It sounds a bit cliche, but I truly became fascinated with the world of medicine by hovering around my father, an emergency room physician. I would sit near him when he ate dinner late at night and listen to the stories he would tell my mother, both shocked and intrigued.” The decision to study medicine was second nature for her, however committing to a specialty was more challenging. “Every field is fascinating in its own way. But in cardiology, we both diagnose and truly fix problems, and have the ability to change the quality of a patient’s life.” It’s not just the medicine she loves though- she values the lasting relationships she is developing with her patients and their families. “In cardiology, you bridge critical care and outpatient medicine in a truly unique way.”
During her fellowship training in Rhode Island, Rao Brito developed an interest in cardiovascular imaging, specifically the influence of 3D echocardiography on the management of structural heart disease. “The advances in imaging technology have really allowed for a personalized approach to the management and treatment of valvular disease.” The idea of personalized medicine is one that Rao Brito tries to champion throughout her practice. More recently, she has become interested in the disparities that exist in cardiovascular care for women.
“Cardiovascular disease remains the leading cause of death in women in the United States and Europe,” Rao Brito states. “And despite significant advances in the field, and an overall decrease in cardiovascular mortality as a whole, this number has plateaued in women. There are several reasons for this- there are clear sex-specific 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 disregard their symptoms. “There is frequently an underlying fear that their symptoms won’t be taken seriously because of the ‘hysteric young woman’ stereotype. We need to bring this awareness to physicians 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 bear children. For instance, women who develop gestational disease or preeclampsia when pregnant have a four-fold higher risk of developing hypertension.
As physicians, it is up to us to enter these little pockets of communities, and build trust.
Meghana Rao Brito, MD
“There are multiple aspects of being a woman that increase your risk of cardiovascular disease. And if that’s not focused on, if someone isn’t looking at those pieces, it’s easy to fall through the cracks. This leads to patients who are overall sicker because you have allowed multiple comorbidities to develop.”
To address these issues, Rao Brito works with her mentor, Lisa Freed, MD, FACC, assistant professor of medicine (cardiovascular medicine) to provide a multidisciplinary approach to heart and vascular disease in women. She has recently started seeing patients at a new location of the Yale Women’s Heart and Vascular Program in Uncasville, CT where she will work with local primary care physicians and obstetricians to provide personalized care to women. Community outreach has been invaluable to her both in educating women about their risk for 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. “As physicians, it is up to us to enter these little pockets of communities, and build trust.”
Aside from her general cardiology practice and her women’s heart and vascular practice, Rao Brito finds variety working with fellows at the Yale New Haven Hospital echocardiography laboratory, and providing cardiology consultative services at Electric Boat through a partnership between Electric Boat and Yale New Haven Health. “Working in a variety of clinical settings keeps this profession interesting and fun.”
Looking forward, Rao Brito is hopeful to continue to grow a multidisciplinary women’s health initiative with the support of the Yale New Haven Health System. “I feel really lucky to have the opportunity to meet the challenges that women’s cardiovascular care has presented. I believe that personalized, multidisciplinary medicine provides the most comprehensive care and I’m excited to be able to deliver this to our patient population.”