Taking advantage of technology
ACCORDING to Malaysia’s Statistics Department, ischaemic heart disease was the principal cause of death among Malaysians in 2016, at 13.2%.
Also known as coronary artery disease or coronary heart disease, the condition occurs when coronary arteries become narrowed due to the gradual build-up of fatty material such as cholesterol and plaque within its walls, resulting in decreased blood flow through the arteries.
This in turn stops the heart from getting the optimal amount of blood and oxygen it needs, which can ultimately lead to a heart attack.
The high number of Malaysians succumbing to heart problems highlights that there is still a greater need for the public to be conscious of their heart health and go for regular health assessments and heart screenings.
According to Subang Jaya Medical Centre’s consultant cardiologist Datuk Dr Yap Lok Bin, among the factors that are stopping people from undergoing heart screenings is the fear of radiation discharged by medical equipment.
However, he assures that there is nothing to worry about as there have been countless technological advancements across the medical industry, and the use of the latest medical equipment such as 256slice computed tomography (CT) scanners by many hospitals allows for simple processes such as heart screenings to become much simpler, quicker and more accurate.
“Classically, patients are always worried about radiation, but the industry has adopted scanners that emit very low levels of radiation during screenings. It is said that the amount of radiation emitted during a calcium score test with the latest CT machines is equivalent to only two X-rays.
“New CT scanners can also take more accurate and defined pictures of the arteries. Moreover, a CT scan is a non-invasive test, unlike a coronary angiogram where doctors would have to put tubes in the body.
“The latest technology is very fast, has very low radiation and is a good way forward for patients being screened for coronary artery disease. CT scanners are no longer limited to diagnostic purposes but can also be used for screening purposes,” says Dr Yap.
The danger of coronary artery disease is that blockage in the arteries is built gradually over time. Patients may not know there is anything wrong with their heart as the disease may not show obvious symptoms. The public must thus be fully aware of the risk factors of the disease, including diabetes, a lifestyle that includes heavy smoking and alcohol, and family history – immediate family members with heart conditions.
As coronary artery disease is more prevalent in males and there have been cases of the disease among patients as young as 30 years old, Dr Yap suggests that it would be wise for male adults to consider going for a cardiac calcium scoring test even before they reach middle age.
The cardiac calcium scoring test is a non-invasive CT scan performed by CT technologists or radiologists to measure the amount of calcified plaque in the coronary arteries. The test can be completed within minutes and the results offer a more accurate predictor of coronary blockages compared to cholesterol screening and other risk factors.
Dr Yap says, “The calcium score is likely to be zero for people below the age of 30, which means the likelihood of getting coronary artery disease is very low at less than 5%.
“A full CT scan or other types of evaluation are only necessary when the calcium score is elevated, and you will then need to see a cardiologist. The discussion for the need of coronary angiogram and angioplasty happens if there is a discovery of a blockage or stenosis.”
Despite the availability of such modern and advanced equipment in many hospitals across the country, the unfortunate truth is that a large number of the population is not going for regular health and heart assessments – a reality that has to change for the better. Dr Yap summarises, “If you have never had any test, then there is always the chance that a heart attack may occur, and unfortunately, heart attacks come in all forms and shapes.”
He adds that with the severity of a heart attack varying between cases, there is the possibility that one’s encounter may lead to fatality.