Are you having a heart attack?
Recognising the signs and symptoms is crucial for quick intervention and can save your life, writes Kasmiah Mustapha
WHEN someone is showing symptoms of a heart attack, it is critical to get him immediate treatment because the longer this is delayed, the less his chances of survival. A heart attack happens when blood flow to the heart is blocked. This deprives the heart of oxygen, resulting in the heart muscles getting weaker every second.
Without treatment, the damage is irreversible. Eventually, the heart stops working.
“Time is life. Any delay in treatment leads to death. It is critical that primary intervention is done within two to six hours. If we can treat it in less than two hours, the survival rate increases from 39 per cent to between 60 and 80 per cent,” says UiTM Private Specialist Centre (UPSC) senior consultant cardiothoracic surgeon Professor Dr Mohd Zamrin Dimon.
Dr Mohd Zamrin, who is also UPSC medical director, says that due to the short window of time, it is important that primary care physicians are aware of the symptoms of a heart attack. The common ones include chest pain, shortness of breath and cold sweat.
Other symptoms are nausea, vomiting, heartburn, general epigastric and arm and upper back pain.
“Primary care physicians must be suspicious when a patient complains of these symptoms. They can immediately use an electrocardiogram to detect ST elevation myocardial infarction, which is an indicator of a heart attack.
“Upon confirmation, they will refer the patient to the nearest hospital that has a heart attack treatment unit.”
ENSURING SEAMLESS ACCESS
ST elevation myocardial infarction (STEMI) is the more severe type of heart attack and the most common. It is brought about by the blockage of the coronary artery. The name is derived from the elevation in the ST segment on the electrocardiogram (ECG), which shows that heart muscles are being damaged.
To ensure heart attack patients receive primary care intervention immediately, the National Heart Association of Malaysia launched the MySTEMI programme in December 2015.
It is based on a hub-andspoke concept, in which selected hospitals will send their patients to a hub hospital with a cardiac catheterisation laboratory and trained personnel. This allows patients to be quickly routed to a facility with specialised equipment and treatment for heart attacks.
However, Dr Mohd Zamrin says, despite the implementation of MySTEMI, many primary care physicians are unaware of the programme, which leads to a delay in diagnosis and treatment.
“The aim of the programme is to ensure that patients are referred to a one-stop hospital within two hours. So it is important that physicians know the nearest hospital that the patient can be referred to.”
UPSC hosted the MySTEMI Update Symposium last year to highlight how the MySTEMI programme works. It was attended by cardiologists, emergency physicians, doctors and paramedics.
Dr Mohd Zamrin says it is important to educate medical experts who may miss the symptoms. This is especially when patients do not display common symptoms or when doctors do not have the patient’s medical history.
“It is also important for patients to know their risk factors and symptoms to further assist doctors in early diagnosis and treatment.
“Previously, high-risk patients comprised those aged 50 and above. But now it is common in people in their 30s and 40s. In fact, the youngest patient I operated on was only 23 years old. If you are aware of the symptoms and you believe you are suffering from a heart attack, go quickly to the nearest hospital. It can save your life.”
Under the MySTEMI programme, UPSC works together with Hospital Sungai Buloh and Hospital Selayang.
UPSC, located in Sungai Buloh, is the hub for Selangor’s northern region and Perak’s southern region. It is equipped with a cardiac catheterisation laboratory where percutaneous coronary intervention (PCI) is carried out in the critical early stages of a heart attack.
Since 2012, UPSC has done more than 300 bypass surgeries and 2,000 interventional procedures. It has adapted the minimally invasive coronary artery bypass surgery method which reduces the risk of wound complications and leads to faster recovery.
Under the MySTEMI programme, the hub hospitals are National Heart Institute (IJN), University Malaya Medical Centre, Hospital Serdang, UiTM Private Specialist Centre and UKM Medical Centre.
The hospitals participating as spoke centres are Hospital Kuala Lumpur, Hospital Ampang, Hospital Tengku Ampuan Rahimah Klang, Hospital Putrajaya, Hospital Banting, Hospital Kajang, Hospital Selayang, Hospital Sungai Buloh and Hospital Shah Alam.