Blazing New Trails in Cardiac Care—with Heart

The Foundation’s 2023 ADM Awardee looks back at a trail blazed

Nanette K. Wenger, MD, MACC, MACP, FAHA, is an icon—and even that is an understatement. Her career in cardiology spans seven decades, her list of professional publications tops 1,700 (with seven more currently under review), and her curriculum vitae, at last count, runs to 172 pages. 

World-renowned for her pioneering research on women and heart disease, geriatric cardiac care, cardiac rehabilitation, as well as her lifelong commitment to promoting equitable care for all, Dr. Wenger has received numerous accolades in the medical community. Indeed, WomenHeart: The National Coalition for Women with Heart Disease’s Wenger Awards bear her name. 

Now, she’s the 2023 recipient of the Alma Dea Morani, MD Renaissance Woman Award, the highest honor bestowed by the Women in Medicine Legacy Foundation. 

Educating her teachers

Dr. Wenger’s visionary career is all the more remarkable because she forged it at a time when women doctors were anything but commonplace.

She first decided to become a doctor in high school. “I loved science, but I’m very much a people person,” she said. “I thought medicine would really combine that.” She declared a pre-medical major at Hunter College before being accepted into Harvard Medical School’s Class of 1954, just the sixth class to include women.

“This had been a male bastion,” she said. “They admitted 10 women to each class, and they were just learning how a co-ed class would perform. We educated them.”

Dr. Wenger found two mentors at Harvard Medical School: Drs. Herrman Blumgart and Louis Wolff, both of whom were cardiologists and clinicians.

“They were just so encouraging and supportive that I knew I was headed for cardiology,” she shared. Just two years after graduating from Harvard, she became the first woman named chief resident in cardiology at New York’s Mount Sinai Hospital.

She was also headed for the South, where she would make even more medical history during her storied tenure at the Emory University School of Medicine, Division of Cardiology.

A Curious Nanette, not a Curious George

Dr. Wenger developed her abiding interest in providing premier cardiac care to women when she realized her women patients at Emory’s Grady Memorial Hospital weren’t receiving it.

“This was one of the golden ages of cardiology,” Dr. Wenger said. “We were beginning to transfer to the bedside what was learned in the laboratory. But in terms of the major diseases—coronary disease, hypertension, heart failure—we never learned anything about women.

“I saw women with these diseases and when I went to the available literature, there was nothing. All I could find were studies that involved middle-aged white men. And because, I suspect, I was a Curious Nanette, not a Curious George, the professional societies that I was involved with really weren’t interested. I kept saying, ‘We need information about heart disease in women.’ No one was interested, but I persisted over the years.”

Shining a light

Her research and clinical efforts paid off. In January 1992, she chaired the landmark National Heart, Lung, and Blood Institute’s Conference on Cardiovascular Health and Disease in Women. The New England Journal of Medicine published the proceedings on July 22, 1993, as a special article. Dr. Wenger was first author on the manuscript.

“The journal editor said that to his knowledge, it was the first time that the terms coronary disease and women were partnered in the title of an article in a major medical journal,” she says.

“This opened the floodgates. One of the things that the paper did was to highlight the knowledge gap and that of course provided a research agenda.”

Her findings showed that not only did women suffer from cardiovascular disease, but their symptoms were often dismissed since they differed from men’s, leading to delayed diagnoses and treatment, and adverse outcomes.

Comparable care for all

Throughout her career, Dr. Wenger has championed providing equitable care to every patient—regardless of gender, race, or socioeconomic background.

“My assumption was that in an indigent care hospital—and Grady is a safety-net inner-city hospital—we can and should deliver the best care possible. And I’ve done things along the way to be sure that happens,” she said.

For instance, as a young doctor during the Jim Crow era, she listened as White patients were addressed as Mr. and Mrs., while their Black counterparts were called by their first names—and promptly told her clerk to use titles for every patient.

“I kept getting reported and I went down to the director’s office every couple of weeks, and after a while, both of us got very bored with it,” she recalled. “He was one of the good ol’ boys, but he could see the handwriting on the wall.”

Similarly, she took action when she discovered that impoverished patients received medications labeled by number. “The assumption was,” Dr. Wenger said, “if you were indigent, you had no education, and I said, ‘This is ridiculous.’”

She used a mimeograph machine to print cards stating medicines’ names and uses. “I wanted my patients to know what they were getting and what it was for,” she said. “Inadvertently, I started one of the first patient information programs in the country.”

Training the next generation

Dr. Wenger has enjoyed a long, fruitful tenure at Emory. In 1960, she became the founding director of Grady Hospital’s cardiology clinics and ECG lab. She attained the rank of full professor of medicine in 1971—a position she holds to this day while also serving as an in-demand author, lecturer, editorial board member, and consultant.

She is equally dedicated to imparting her vision of equitable patient care to future medical professionals. “I told them that it was their responsibility to see that patients received comparable care, comparable respect, and comparable concern,” she said of her days doing rounds with medical students at Grady.

Her pedagogy extends to the written word, too. She invites junior faculty members and trainees to be lead author on publications while she serves as senior author, thereby teaching them how to write papers that will get accepted for publication and how to present their findings.

It’s all part of paying it forward. “I was mentored by so many fabulous people, I felt the need to mentor back, both men and women,” Dr. Wenger shared.” I emphasize to women that because of where they have progressed, they have the responsibility both to mentor and to sponsor their female colleagues and trainees.”

The way forward

Reflecting on her prodigious contributions to cardiovascular medicine, Dr. Wenger offered, “We’ve begun the journey, but it is far from complete. There’s no question that there’s more work to be done.” She notes that women patients remain understudied, underdiagnosed, and undertreated.

She has sage words for the women who are just beginning their medical journeys and will someday advance her work.

“Find out what excites you, makes you want to go to work in the morning, and makes you satisfied at the end of the day,” she said, “and follow your passion. Don’t hesitate to explore things that are uncertain or unknown.

“That is what I have done and that is what has given me so much satisfaction.”

Dr. Wenger will accept the Alma Dea Morani award and deliver her remarks, “Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care” at a virtual event hosted by the New York Academy of Medicine on Thursday, October 26, 2023.

Dr. Wenger will be introduced by the 2008 Alma Dea Morani Renaissance Woman Award recipient, Dr. Ellen R. Gritz.