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BackgroundThe proportion of women as leading physicians in cardiology in university medicine has stagnated and the share of women in senior positions in cardiology is low compared with other medical specialist fields. Here, we analyze the typical barriers for women as doctors in cardiology and point to issues that make the discipline less attractive for both genders.MethodsIn a cross-sectional study, a standardized online questionnaire was sent to 3873 members of the German Cardiac Society (DGK). Answers from 567 (278 women, 289 men) were analyzed, using comparisons between groups, correlation analyses, and tests of normal distribution.ResultsFor 47.4% of respondents (52.0%, of women; 42.8%, of men; p = 0.049), training had lasted longer than anticipated. Average monthly gross income (full-time work) differed significantly between women and men as specialists (p = 0.004) and assistant doctors (p = 0.030). Of women, 32.1% had experienced sexual harassment in the workplace. The main arguments against a career in university medicine were an extremely competitive working climate (66.7% of women, 63.2% of men), lack of work–life balance (66.7% women, 55.3% men), and excessive workload (57.8% women, 62.5% men). As strategies to increase job attractiveness, both mentioned measures to improve the work–life balance, and the flexibility of working times and improved financial provision. Women asked for gender balance at management level (76.3% vs. 32.9% of men) and opportunities for sharing management tasks (82.4% vs. 57.9%). Flatter hierarchies were requested by more men (67.1 vs. 54.8%).ConclusionFurther development of the work culture in cardiology seems necessary. In order to increase the attractiveness of the field overall and to provide equal opportunities in cardiology, more targeted support should be provided to young doctors and more flexibility introduced into work.

ZusammenfassungFrauen mit bekannten Herz-Kreislauf-Erkrankungen und Kinderwunsch sollten rechtzeitig vor der Schwangerschaft eine umfassende Beratung erhalten. Diese ist als Grundlage einer informierten Entscheidungsfindung für Mütter und deren Familien unabdingbar. Des Weiteren sollte ein Behandlungsplan interdisziplinär erstellt und mit den Patientinnen besprochen werden. Zur Risikobewertung in der Schwangerschaft sollte die modifizierte Klassifikation der Weltgesundheitsorganisation (mWHO) verwendet werden. Auch wenn es sich bei Erkrankungen der Aorta um seltene Pathologien handelt, sind diese häufig lebensbedrohlich. Herzklappenerkrankungen sind häufiger. Aufgrund neuer Möglichkeiten in der Chirurgie und der Antikoagulation stellt die Therapie von Herzklappenerkrankungen eine besondere Herausforderung dar. Kardiomyopathien in der Schwangerschaft können Todesfälle und schwere kardiovaskulärer Komplikationen, wie eine fortschreitende Herzinsuffizienz oder thromboembolische Ereignisse, verursachen. Mittlerweile sind jedoch neuartige Behandlungsmöglichkeiten verfügbar.