5 Questions with Annabelle Santos Volgman, MD
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For this issue, Cardiology Today spoke with Editorial Board Member Annabelle Santos Volgman, MD, FACC, FAHA. She is the Madeleine and James McMullen – Carl E. Eybel, MD Chair of Excellence in Clinical Cardiology Professor of Excellence in Clinical Cardiology and the vice chief for academic affairs in the division of cardiology at Rush University Medical Center. She is also the co-founder and medical director of the Rush Heart Center for Women.
Volgman received her medical degree from the Columbia University College of Physicians and Surgeons in 1984 and spent her residency at the University of Chicago Hospitals and Clinics. She completed fellowships in cardiology and cardiac electrophysiology at Northwestern University Memorial Hospital in 1990. She has been at Rush since 1990.
Volgman has been a leader of the American Heart Association’s Go Red for Women campaign since its inception and wears red every day to raise awareness that heart disease is the leading cause of death in women. She serves on the national scientific advisory board of WomenHeart and on leadership committees of the AHA and the American College of Cardiology. She is governor-elect of the ACC’s Illinois chapter. She has published numerous articles and editorials and has won various honors, including WomenHeart’s Wenger Award for Innovation in Heart Care for Women and the Woman’s Day Red Dress Award.
Cardiology Today: What area of research in cardiology interests you most right now?
Volgman: There are so many things. I am an electrophysiologist by training and have done a lot of work in atrial fibrillation. Because of my husband’s parents’ history of Alzheimer’s disease, I became very interested in cognitive impairment and Alzheimer’s. I found out that what can decrease cognitive impairment are the same things we tell our cardiology patients to do to be heart-healthy: eat right, exercise, decrease your BP and cholesterol, etc. So I started looking at the connection between CVD and cognitive impairment about 15 years ago. There are a lot of similarities.
Rush has a well-known program in Alzheimer’s disease, and I started working with Neelum T. Aggarwal, MD, a neurologist who was also very interested in the CV impact on cognitive impairment. She started seeing patients with me in the Rush Heart Center for Women, and we have done a lot of studies on the CV impact on cognitive impairment. My work in AF has led to more work with cognitive impairment, because a lot of people with AF have transient ischemic attacks, unrecognized or asymptomatic strokes, etc, all of which affect their cognition.
Cardiology Today: What advice would you offer a student in medical school?
Volgman: Follow your passion. Don’t narrow your interest until you become passionate about something.
I wanted to be in the health care field from when I was 8 years old. At first I wanted to be a nurse because my aunt was one. I came to the U.S. when I was 12 and met another aunt who was a doctor. She said, why not be a doctor? From age 12 until when I got into medical school, my goal in life was to become a doctor. Once I became a doctor, I wasn’t sure where I wanted to go from there. I did not know what kind of a doctor I wanted to be and I did not have any goals to dream of working so hard to become.
It wasn’t until my fourth year of medical school, in 1983, when I found my passion in cardiology. Then, I found out you can abort a MI by giving tissue plasminogen activator or performing angioplasty, which had just started to become the practice in the U.S. That made me want to do cardiology. I became directed again and had another dream to fulfill. Once I became a cardiologist, I did not need anything else to make me work hard, because I had found what I wanted to do. I wanted to be the best cardiologist I could be.
So my advice would be, look at all the different things that medicine has to offer, then figure out what really makes you excited, and makes you want to do your best.
Cardiology Today: Have you ever been fortunate enough to witness or to have been a part of medical history in the making?
Volgman: When I was a cardiology fellow in the 1980s, defibrillators were first being implanted. I was at Northwestern, where we did some of the first trials of implantable cardioverter defibrillators and of catheter ablations for Wolff-Parkinson-White (WPW) syndrome. We were doing all these amazing procedures in electrophysiology in the OR. I saw the transition from opening up the chest and doing surgical ablation to doing catheter ablations, and from opening the abdomen to put in large defibrillators to making a pocket in the chest. It was amazing to be a part of that.
I was also part of the teams that first used the drugs that are now part of guideline-directed medical therapy. We were among the first to study whether warfarin reduced stroke in patients with AF. We didn’t know the answer to that in the 1980s. We studied the class 1c drugs for patients after a MI and found out we had been increasing mortality with what we had been prescribing. I was a fellow and a new attending when all those trials were being done, so it feels like I experienced the history of cardiology.
In addition, the AHA contacted me when it decided to focus its attention on women and heart disease. Around 1998, we realized more women were dying of heart disease than men, and the gap was becoming wider. The AHA approached me about efforts to create awareness of heart disease in women. I was there at the beginning for the Women’s Legacy Luncheon, the precursor to Go Red for Women. I was incredulous that women were dying of heart disease, but we were not aware of it. We were taught in medical school that heart disease is a man’s disease and women hardly get it. But there was a disconnect with reality. I had patients tell me that their cardiologists were telling them their palpitations were from nerves or stress and wouldn’t even give them an ECG, but one patient ended up having WPW. I was infuriated that cardiologists would dismiss women just because they were women, and I became passionate about health care disparities in women. Some of my focus now has also gone into racial disparities in health care, a passion I share with my daughter Caroline.
Cardiology Today: What are your hobbies outside of practicing medicine?
Volgman: I love to read and I belong to a book club. I usually take the month of August off and learn something new during that month. One summer I learned how to paint. Another, to make sourdough bread. Another, to make pasta. The idea is to learn skills I would not normally do.
My husband, whose support has enabled me to achieve what I have in my career, spent most of his career as a mortgage broker but has become more interested in developing property. As a family, we have built houses near our property in Michigan. We wanted to do something with our children that would teach them about business and money. So far, we have built 12 houses that we rent out, and we get so much joy from reading reviews that the houses gave them such great memories with their families.
Cardiology Today: What’s up next for you?
Volgman: I would like to transition from mostly patient care to mentoring, and maybe becoming a consultant for organizations to educate patients and physicians. I would like to mentor young women and young doctors to become successful and fulfilled in their careers.
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