A DIF­FER­ENT KIND OF HEART­BREAK

Sta­tis­tics show that there is a steady in­crease in the num­ber of in­ci­dences of heart at­tacks and heart fail­ures among adults below 55 years of age.

Herworld (Malaysia) - - CONTENTS -

Why younger peo­ple are hav­ing heart at­tacks.

Look up in­for­ma­tion on heart at­tacks and you’ll no­tice that the risk fac­tor rises sharply with age, with women aged 55 years and above most at risk (for men, it’s 45 and above). Now, how­ever, younger peo­ple are in­creas­ingly notic­ing some­thing wrong with their heart. “In the last five years or so, I’ve seen an emerg­ing trend in car­dio­vas­cu­lar dis­eases in the younger pop­u­la­tion. Pre­vi­ously with heart at­tacks, we’ve only seen it hap­pen with pa­tients who are 55 years and above,” says Dr Yap Swee Hien.

QWhat are the causes of heart at­tacks among younger adults in Malaysia?

“One of the ma­jor fac­tors con­tribut­ing to this is an un­healthy diet, with easy ac­cess to fast food. An­other ma­jor con­tri­bu­tion to the rise in in­ci­dences is smok­ing. We are see­ing more young peo­ple who smoke. A seden­tary life­style is also one of the con­tribut­ing fac­tors, as more young peo­ple are not ex­er­cis­ing or do­ing enough of it. That said, the aware­ness of coro­nary artery dis­ease among this age group has sig­nif­i­cantly im­proved due to easy ac­cess to in­for­ma­tion via the in­ter­net. More health-con­scious adults are at­tend­ing yearly health screen­ings.”

The symp­toms of coro­nary artery dis­ease are chest pains, usu­ally left-sided or cen­tral, that’s ag­gra­vated by move­ment or ex­er­cise.

QWhat are the symp­toms of coro­nary artery dis­ease that leads to heart at­tack?

“The symp­toms of coro­nary artery dis­ease are chest pains, usu­ally left­sided or cen­tral, that’s ag­gra­vated by move­ment or ex­er­cise. The pain may ra­di­ate to the left fore­arm and left up­per-jaw re­gion. It’s also as­so­ci­ated with per­spi­ra­tion and nau­sea.”

QCould you pro­vide an ex­am­ple of a case study that il­lus­trates the in­ci­dence of heart at­tacks in younger pa­tients?

“A 42-year-old gentle­man with no known med­i­cal ill­ness came to see me some time ago for a car­diac health screen­ing. He didn’t have any symp­toms and played bad­minton reg­u­larly. How­ever, he was a heavy smoker and had been smok­ing since he was 16 years old. We per­formed an ex­er­cise stress test and de­tected ev­i­dence of re­duced blood sup­ply to the heart. Hence, I coun­selled him to un­dergo a coro­nary angiography, a pro­ce­dure to as­sess his coro­nary ar­ter­ies. He was hes­i­tant ini­tially as he claimed to be symp­tom-free and had been feel­ing well.

Af­ter much con­vinc­ing, he fi­nally agreed to do it and what we found was that he had a se­vere nar­row­ing in one of his main coro­nary ar­ter­ies. Coro­nary an­gio­plasty, a pro­ce­dure to re­lieve the nar­row­ing of the coro­nary artery by bal­loon­ing and stent im­plan­ta­tion, was per­formed. While shocked about his an­gio­graphic find­ing, he was re­lieved that the pro­ce­dure was able to un­block the artery.

The sever­ity of the sit­u­a­tion was that had he not un­der­gone the car­diac health screen­ing, he may have had a heart at­tack lead­ing to sud­den death – es­pe­cially dur­ing stren­u­ous ac­tiv­ity such as when play­ing bad­minton.”

QWhat are some of the di­ag­nos­tic tests that you would do to in­ves­ti­gate heart con­di­tions?

“There are a few tests that we con­duct. The first is the elec­tro­car­dio­g­ra­phy to as­sess the heart’s rhythm and elec­tri­cal ac­tiv­ity. An­other im­por­tant in­ves­ti­ga­tion is echocar­dio­g­ra­phy, which is an ul­tra­sound of the heart that helps us dis­cover its struc­ture and func­tion. As for as­sess­ing the coro­nary ar­ter­ies or blood sup­ply to the heart, one of the com­mon­est meth­ods is the ex­er­cise stress test, where the pa­tient runs on a tread­mill. We mon­i­tor the ECG to look for ev­i­dence of a lack of blood sup­ply to the heart as the pa­tient ex­er­cises. Other modal­i­ties of in­ves­ti­ga­tion in­clude CT and MRI scans of the heart, as well as coro­nary angiography.”

QWhat is your ad­vice for pre­vent­ing car­dio­vas­cu­lar dis­eases in younger adults?

“Preven­tion is bet­ter than cure. The first thing is your diet – it’s im­por­tant to eat healthily. The sec­ond is ex­er­cise. I un­der­stand that for young adults, sched­ules can be tight due to work. But it is im­por­tant to pri­ori­tise health and ex­er­cise. The third is smok­ing. For those who have not started, please do not and for those who have been smok­ing, please con­sider quit­ting. It has tremen­dous side ef­fects that not only af­fect your heart, but also in­creases your risk for can­cers and lung dis­ease. And the fi­nal thing is just to have reg­u­lar check-ups or health screen­ings with med­i­cal pro­fes­sion­als.”

Dr Yap Swee Hien, con­sul­tant in­ter­ven­tional car­di­ol­o­gist, Prince Court Med­i­cal Cen­tre

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