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    Women & Heart Q&A

    Dr. Prasanna Yelamanchili Cardiologist, The Heart Group 10/25/2021

    Dr. Yelamanchili has been practicing in Evansville for more than 10 years, and in that time she has cared for hundreds of women with heart disease. She recently sat down for a Q&A about some important women’s heart health questions.

    How common is heart disease in women, and how is it different for women than men?
    Currently, heart disease kills more women than men, and it causes more deaths than all forms of cancer combined. Two-thirds of women who die of heart disease have no prior symptoms and women die twice as often after a heart attack as men do. As you can see, heart disease is a serious and real threat to women.

    Even when a woman has a heart attack, they will often have very different symptoms than when a man has a heart attack. We’ve all heard of the “crushing” pain in the chest, pain radiating down the left arm, etc. that are common with heart attacks in men.

    In women, heart attack symptoms are more likely to include:

    • Lightheadedness
    • Shortness of breath
    • Feeling of indigestion/heartburn
    • Nausea & vomiting
    • Sudden weakness/fatigue
    • Upper back pain
    • Jaw/toothache-like pain
    • Arm pain (but not always)

    I often see that women are so busy caring for everything and everyone that they tend to ignore their symptoms and end up going to the emergency department later than men do. This delay in treatment can lead to worse outcomes. Because of the prevailing view that heart disease is a man’s disease, women don’t think it’s happening to them.

    If you have a strong family history of heart disease should you be screened and if so how often? Are there any specific signs or symptoms you should watch for?
    There are no definite guidelines for screening patients based solely upon family history. That said, if you have a family history of heart disease (especially early heart disease--as under the age of 55 for men or 65 for women), then you should partner with your doctor to both decrease your risk and screen for risk factors. For any woman who has this type of family history, she needs to be aware and take actions in her life that help reduce her risk of developing heart disease.

    While family history is a factor, it doesn’t mean everything. It is important that everyone, regardless of family history, does the following to reduce their risk:

    • Do not smoke or use any tobacco or nicotine product.
    • Maintain a healthy weight
    • Eat a heart-healthy diet (more on that in bit)
    • Get at least 150 minutes per week of heart-rate-increasing exercise

    Is it beneficial to be prescribed a statin drug to prevent heart attacks and/or strokes in women with no current risk factors, just a family history of heart disease?

    If a woman has a strong family history of heart disease, and her bloodwork/screenings indicate that her cholesterol is high enough to be treated, then a statin may be appropriate, but must be accompanied by lifestyle changes. Often times, I will give women the option to work very hard on lifestyle changes for six months or so, and then recheck their bloodwork.  We’ll decide together at that time if a statin should be considered.

    Is there evidence that taking hormones during and after menopause increases the risk for heart disease?
    Yes, there is significant evidence that there is an increase in heart disease/stroke risk in women who have taken hormones. The risk is related to how long the woman took the hormones. If a woman is experiencing significant menopausal symptoms that are affecting her ability to live a normal life, hormones should only be considered for as short of a period of time and at as low of a dosage as possible to get her through the symptoms short-term.

    Are there certain foods to eat or avoid that can help prevent heart disease in women? 
    This is one of my favorite topics to discuss, because I do agree with Hippocrates: “Let food be thy medicine.”  I have particular recommendations for my patients that I and my family follow as well. I admit that with two teenage children, it’s impossible to be perfect. But, perfection isn’t the goal. If you can make sure that 90% of what you eat follows these guidelines, you’ll be far healthier and feel better:

    • Avoid processed foods. If it’s in a box, has a long shelf life, or a big list of ingredients (especially some that you can’t pronounce), then it’s processed. Eat whole foods instead.
    • Eat a rainbow of colors everyday of fruits and vegetables. Start each meal with a salad or fruit, for example.
    • Avoid fried foods.
    • Limit refined carbohydrates. Aim for whole grains, like quinoa, oats, etc.
    • Limit animal fats. For proteins, steer clear of red meat—especially commercially-raised.
    • Get healthy fats from nuts, avocados, and oils (portion sizes matter because all of these are high in calories).

    What can mothers do for our children to help them avoid heart disease when they are older?
    I love this question. Helping your children become active and stay active through life is one of the greatest gifts you can give them. Make fitness a family affair with walks after dinner, weekend hikes and bicycle rides, etc. Also, develop healthy eating habits. Even improving the quality of snacks, such as eating fresh produce instead of packaged processed “junk food” can go a long way. Soft drinks are terrible. The sugars and other ingredients in them are toxic to the health of everyone. Childhood obesity is on the rise, and I worry about upcoming generations. They may actually have shorter life spans than their parents, which is a tragedy.

    Learn more about heart health and upcoming heart-health events by visiting


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