This doctor's calling is to heal hearts

Stephen Tann has joined Carson Heart Physicians and is the newest cardiologist on staff with Carson Tahoe Regional Healthcare.

The 34-year-old doctor has his undergraduate degree from the University of Notre Dame, attended Ohio State University College of Medicine and completed a cardiology fellowship in Charleston, S.C., in 2004.

What are some words of inspiration that you live by?

'Our Father...'; Cultivate simplicity, humility and equanimity.

Why have you relocated to Carson City?

I was interested in finding work in an area close to the mountains. When I learned of the opportunity with Reno Heart Physicians, I was excited by the prospect of working in a new hospital with a group that was committed to expanding a cardiac program into a community that had a real need for such.

Why did you decide to become a cardiologist?

My feeling was - and is - that cardiology as a field offers a unique combination of the intellectual rigor of internal medicine, along with the opportunity to perform procedures that have a real chance of bringing about immediate, positive benefits to one's patients.

It is estimated that 2-3 million U.S. women may suffer from microvascular cardiac disease that is not being diagnosed by conventional detection methods. What is Carson Tahoe Regional Medical Center doing about this?

As I am quite new here, I don't know the entire extent of Carson Tahoe Regional Healthcare's community outreach programs yet. However, I do know that it is very invested in community education about the risk of cardiac disease in women. Further, from what I have seen so far, it appears that the medical community at this hospital is very aggressive in looking early for the presence of 'small vessel' or microvascular coronary disease, and managing it early through aggressive cardiac risk factor modification.

In what ways is heart disease different in men and women?

The primary difference would be the age at which heart disease typically manifests itself. Before going through menopause, women receive a real protective effect on their heart by their unique female hormones. However, once women experience life's change, this protective effect is lost, and their risk for heart disease rapidly catches up to that of their male counterparts. Also, in terms of coronary syndromes - angina, heart attacks - the clinical presentation in women tends to be more atypical than in men. In other words, women less frequently exhibit the classic heart attack presentation of crushing substernal chest pain which radiates to the left arm with nausea, sweating, and shortness of breath than do men. Signs of heart disease in women tend to be more subtle.

It seems like more information about heart disease in women is out now. Why did it take until the late 1990s-2000 for revelations about the disease in women?

Prior to that point, long-term, population-based studies had not yet been available that would have raised any alarms about the prevalence of heart disease in women. But about that time, the medical community began to see more long-term epidemiologic data that showed the rapid increase in the incidence of heart disease in women in their fourth and fifth decades of life, the perimenopausal period. Prior to this data, we were all operating under the assumption that the cardioprotective benefit of estrogen extended beyond menopause. Studies in the late '90's showed us that this was not indeed the case, and that it only took five-10 years after the age of menopause for women's risk for heart disease to become equal to, and even surpass, that of men of the same age. This was a real revelation in the world of cardiology.

What symptoms should family members watch for?

Obviously, one needs to be aware of the classic signs and symptoms for coronary syndromes: episodic chest pain which comes on with exertion and is relieved with rest; is associated with nausea, vomiting, and breaking out in a cold, clammy sweat; pain which radiates from the chest into the neck, jaw, or arms. This is angina, and it needs to be taken seriously with prompt medical attention. But people also need to be aware of more subtle signs of heart disease: a decrease in the ability to exercise or exert oneself, unusual shortness of breath with exertion, unusual fatigue and lack of energy, difficulty breathing when lying down flat, swelling in the feet or ankles. All these can be signs that more slowly developing problems with the heart exist, and they also merit prompt medical attention.