Dr. Romeo Pavlic is one animated cardiologist. Even though he founded Inland Cardiology Associates 23 years ago, he still takes joy in his work. During an interview, he takes cell phone calls, then bounces out of the room to return with an oversize model of the human heart, displaying the enthusiasm of a born teacher as he points out the 90-degree turn that this vein over here makes -- see? -- as it wraps itself around that ventricle over there.
"My name is Romeo, and I am dealing with hearts!" he exclaims, and even though you know he's told the joke many times before, his gusto remains infectious.
The Croatian-accented English of Pavlic grows somber, however, as he recounts his personal reasons for his interest in women's heart disease. "This is a very sad, sad situation," he says. "My sister died, about four and a half years ago, of a heart attack. She was younger than me -- only 47 years old -- and that is when it really hit me, and I started to look into what is really going on.
"My sister was a cardiac nurse down in Palm Desert, [Calif.]," he says. She is having 'urps' -- it is Italian food; she thinks she is just having reflux -- and her kids (they were 12 and 16 then), they are saying, 'Mom, you are telling us all the time about women who have heart disease.' They want to send her to a doctor. But she was laughing -- she says, 'Everyone knows me there. I do not want to be hypochondriac.' And within four hours, she was dead."
Pavlic's personal loss brought home the dimensions of the problem to him. "About 50,000 more women are dying than men of heart disease in the United States every year," he says. "And these are the young women, not just the ones in their 80s and 90s, who are leaving their husbands and children behind. They are dying of heart attacks, and that's because their symptomatology is different, and we are not astute enough."
Pavlic notes that women display more fatigue than chest pains prior to heart attacks. His wife Dorothy, who works with him coordinating medical relief efforts in Belize and elsewhere overseas, adds that "A tired woman could be presenting with heart disease, but our society says, 'Oh, she's a mother, she has a job, she's just overworked.'"
Through hard work, Pavlic is becoming more astute about women's heart disease. He's involved in a 10-year study of Spokane residents -- and preliminary findings suggest that high levels of triglycerides (blood sugars) may be implicated in heart attacks suffered by middle-aged women. In addition, he says, "We didn't know until this year that women, if you give them a treadmill test prior to cycle and then after the menstrual cycle, you will get different results."
Pavlic is big-hearted in other ways, too. He and his wife have adopted and raised five children from other countries -- along with their three biological children. And currently, you'll find two trailers in their back yard being loaded with medical supplies and machines to be driven down to Belize to be donated to clinics he works with there.
Pavlic is emphatic about a lot of things, but especially about the need for young people to get the proper heart-related tests done. "In the schools, they need to really hit cardiovascular risk factors," he says. "The legislature will need to get involved. They need to pass a law that everybody, when they finish their high school -- that young people can be tested without fear of repercussions -- that if they are high-risk, that some insurance company won't be able to get their records."
His wife, Dorothy, agrees: "It should be anonymous, like they do AIDS testing," she says. "Also the funding needs to be there, because healthy people cannot afford it, because insurance companies say, 'You don't need this, you're healthy.'"
Both of them emphasize the need for even healthy-appearing people to get heart tests done. As Dr. Pavlic says, "Half of the people who have heart attacks have normal cholesterol. This is a very sneaky disease."