Miami Cardiologist Minerva Santo-Tomas is Living Her Childhood Dream
by Natalie P. Mcneal
At age five, Minerva Santo-Tomas ripped the stuffing out of her teddy bear’s chest, replaced it with tissue and attempted to sew the stuffed animal back together.
“It’s got a broken heart and I’m going to fix it,” the Miami cardiologist now recalls telling her parents. “This is what I’m going to do when I grow up. Fix broken hearts.”
The daughter of Cuban immigrants, Dr. Santo-Tomas is living her childhood dream through her practice, the Miami Cardiovascular Prevention Institute and as medical co-director at South Miami Hospital, Women’s Heart Center. As a cardiologist, Dr. Santo-Tomas has made it her life’s work to help women protect their heart health.
“An educated patient is an empowered patient,” says Dr. Santo-Tomas, 46.
Q Who is at risk for having a heart attack?
A More than 1 in 500,000 women will suffer a heart attack this year. It is the leading cause of death of women in this country. One out of three women will die as a result of a cardiac-related event. In particular, Hispanic and African Americans are at a greater risk of having cardiac events at an earlier age. A lot of that is due to the social aspect of our communities—our meals, what we eat, our stress level, genetic predisposition and economic situations. The health care may not be as available.
Q If you had to profile a woman who is most at risk for heart disease, who would she be?
A A 65- to 70-year-old woman, diabetic, African American or Hispanic, with a family history, usually sedentary—but not always—and a smoker. I take those women very seriously.
Q How can someone at home tell if they have risk factors?
A Websites like WebMD and the American Heart Association have risk-factor calculators. You can figure out what your risks are and the probability of having a heart attack in 10 years.
Q What are women facing when it comes to heart disease?
A If you are a woman and you have a heart attack, your chances of surviving are much worse than a man’s. Recovery from a heart attack is much more difficult. It’s how we’re built, and the disease type is a little different in women.
When they start to feel the symptoms, many women discard them as non-cardiac. [Women may make excuses like,] “Oh it’s heartburn. I have to take care of the kids, my husband, my parents or friends.” So they ignore the symptoms. On average, they get to the hospital an hour or two later than a man would.
When they get to the hospital, they are treated later than men. Many times they are not treated by a physician but by a physician’s assistant. So from the very beginning when women start having cardiac events they are already getting the raw end of the deal.
Q How much does obesity play a part in heart disease?
A Just because you are obese, that doesn’t mean you are going to have heart disease. It has to do with how well you take care of yourself. You can be obese but be fit. I have a lot obese patients that I do stress tests on and they actually go longer on the treadmill than some of my more normal, average-weight patients who don’t get off the couch. It has to do with activities and how you eat—not just what you eat. Also, stress is a major component of cardiac events. It may not cause the disease but it can trigger a cardiac event like a heart attack or stroke.
Q It’s not what you eat but how you eat it? Please explain.
A Portion control. Many people overeat because our society tends to think that more is better. Being a Hispanic, if you don’t eat everything on your plate it’s almost an insult to the person who is feeding you. We’re brought up that way. There are many foods that we eat that aren’t that unhealthy, but if we are eating a meal full of carbs or starch, and then we’re having dessert, and we’re sitting on the couch and watching television and not moving our bodies, that combination is far worse than having a Twinkie and then working out and doing something to counteract it. There are many food groups that, if they are eaten correctly with smaller meals and snacks in between and exercise, you’d be OK.
Q How should you discuss your heart concerns with your doctor?
A When you have a symptom that you need to talk to your doctor about, you tell him, “Listen, doc, I’m serious about this. This is what I’m feeling and I’m very concerned about this and I’ve done my research.” Walk in ready, prepared to ask questions. We’re in the 21st century; we have to involve ourselves as a patient.
Spend time studying what you are feeling. It’s better to come in being able to describe and explain what you’re feeling. If we physicians have to pull things out of a patient, then we may not be describing accurately what’s going on.
Q What are the trends that you are seeing in patients?
A At the beginning [of starting my practice 12 years ago], I rarely saw women who were concerned about their hearts. They would see me if they complained to a doctor that they had chest pains. What I’m seeing more of is women who are reaching a critical age, usually in their 50s, who have a family member who’s had a heart condition. They are aware of their risk factors and want to undergo an evaluation to determine if they have heart disease. I am seeing a growing awareness among women and fearlessness among women to pursue their discovery of any potential heart disease.
Q So, because you’re a cardiologist— I’m sure that means you are serious about exercise and health. What’s your exercise regimen?
A I tell my patients to do what I say, not as I do. Doctors are terrible patients. I try to exercise 30 minutes a day, three times a week. I don’t smoke and I try to have a salad every day. I try to find 30 minutes each day to do something that really gives me joy—whether it’s watching a really silly television show or playing with my dogs. People need to find things to de-stress.
PHOTO: Clarence Griffin for Heart & Soul