Matters of the Heart: Heart Stopping Killer

According to the World Heart Federation, heart disease is the world’s leading cause of death, causing one in three deaths. And adding to the bad news, men are three to five times more likely to contract heart disease as compared to women.

“Though the figures may be disheartening, heart diseases can be prevented, managed and treated,” said Dr Ng Wai Lin, Consultant Cardiologist, Raffles Heart Centre. “Using medicines,
changing diet, exercise and lifestyle habits, and opting for surgeries and even heart transplants, can help sufferers of heart diseases.”

Coronary Artery Disease

Coronary artery disease is one of the leading causes of death in Singapore. However, it can be prevented by managing its risk factors.

Risk factors for coronary artery diseases can be largely divided into non-modifiable factors and modifiable factors.

Non-modifiable risk factors:

Increased age
Male, and female after menopause
Ethnicity; South Asians and Malays are at higher risk than Chinese
Family history

“While you can’t change your gender, your family and the fact that you age, there are modifiable factors that could vastly improve your chances of having a healthy heart,” said Dr Ng.

Modifiable risk factors:

High blood cholesterol
High blood pressure / hypertension
Diabetes mellitus and abnormal blood sugar levels
Menopause
Obesity
Physical inactivity
Smoking
Stress

How Your Heart Works

The heart is a fist-sized organ that pumps blood in the body. Oxygen-poor blood enters the right upper chamber, flows through the right lower chamber and through the pulmonary artery to the lungs where the blood is enriched with oxygen. The oxygenated blood is then carried back to the left upper chamber of the heart into the left lower chamber and then pumped out to the rest of the body. This important process is necessary for the cells in our organs and body to function.

Heart Failure

Heart failure occurs when the heart loses the ability to pump enough blood to the body’s tissues, resulting in insufficient oxygen and nutrients for proper functioning of the main body organs and
other tissues. Our brain cells can die if deprived of oxygen for more than three minutes. Our muscle cells live on for several hours while our bone and skin cells can stay alive for several days.

Blockages in the arteries (coronary artery disease), disease of the heart valves and irregular heartbeats (arrhythmia) are common causes of heart failure.

Causes

The most common causes of heart failure are:

Coronary heart disease and
heart attack (which may be “silent”)
Cardiomyopathy (disease of the heart muscles)
High blood pressure (hypertension)
Heart valve disease
Congenital heart disease
Alcoholism and drug abuse

Symptoms

A person with heart failure may experience shortness of breath and coughing caused by the fluid build-up in the lungs or pulmonary oedema. It may cause the person to cough up bubbly phlegm
containing blood. Other symptoms of heart failure include fluid build-up in the veins and body tissues causing swelling of the feet, legs and abdomen. When body tissues, such as organs and muscles, do not receive enough oxygen and nutrients, they cannot function well, leading to tiredness and dizziness.

Detection

Diagnosis of heart failure is based on:

Symptoms
Medical history
Physical examination
Chest radiograph
Electrocardiogram (ECG)
Other imaging tests
Cardiac catheterisation

Treatment

Heart failure is usually treated with lifestyle changes and medicine. Sometimes, surgery is required to correct abnormalities of the heart or heart valves.

Congenital heart defects and abnormal heart valves can be repaired with surgery. Coronary artery diseases can be treated with angioplasty or a heart bypass surgery.

For patients with severe heart failure, the heart muscle may become so damaged that available treatments are unable to help. End-stage heart failure patients can consider heart transplantation.

Other than lifestyle modifications, medical advances are at hand to help. With this arsenal of modern know-how, heart diseases need no longer to be as fatal as they used to be. HN

Tips for a healthy heart

Food for thought
Avoid high cholesterol food and saturated fats. Choose lean meat, fish and low-fat dairy products instead and increase your intake of fruit and vegetables.

Active lifestyle
Exercise at least three times a week to prevent heart and blood vessel diseases. Although there are many kinds of physical activities, brisk walking is one of the best. Check with your doctor to see what is suitable for you.

Stop smoking
Heart disease is more common in smokers. Smoking is a major contributor to heart disease risk. High-risk groups also get heart diseases earlier. To reduce your risk of getting heart disease, stop smoking.

Weight watch
Maintaining a healthy body weight reduces the risks of heart disease. To give you a good idea of whether you are keeping a healthy weight, your Body Mass Index [BMI = weight (kg) / Height (m) x Height (m)] should not be more than 23. The waist-to-hip ratio is another useful guide. A ratio of more than 0.9 for men and 0.85 for women indicates increased health risks.

Relax
Manage stress by engaging in regular exercise. It is important to have work-life balance. As
far as possible, relax to ease the tension whenever feelings of stress arise since stress may
aggravate heart disease.