Beware Of Heart Failure

KUALA LUMPUR, 30 September 2020: Living with heart failure can be terrifying. But people need to know that the condition is preventable, treatable and manageable. People living with heart failure need treatment for the rest of their lives, according to a cardiologist.

“There is effective medication to treat people with heart failure. Treatment improves heart failure symptoms and quality of life, reduces hospitalisation and helps patients to live longer, ” says Datuk Dr David Chew Soon Ping, consultant cardiologist at Cardiac Vascular Sentral Kuala Lumpur.

“Heart failure is a chronic condition whereby the heart can’t pump enough blood to meet the body’s needs. The older you are, the more likely that you may get heart failure. However, this does not mean that heart failure does not affect younger people.”

Up to 10% of those above 65 years of age may develop heart failure. It is also the most common cause of hospitalisation among this group.

Some of the common causes of heart failure include coronary artery disease and heart attack, hypertension, heart muscle disease or valve disease.

Dr Chew points out that medications need to be continued long-term and the challenge with some heart failure patients is medication compliance – they don’t take their medication as directed by their doctors. In some cases, patients stopped their medication without consulting their doctors. This usually results in worsening of their condition and may lead to hospitalisations and death.

Besides medication, other treatment options include implantation of electrical devices, or surgery – if patients have severe coronary artery disease or valve conditions, and in extreme cases, heart transplant.

For people in risk groups (high blood pressure, diabetes, high cholesterol and obesity), Dr Chew recommends: “Treat these conditions appropriately to prevent the development of heart disease that can later on lead to heart failure. Watch your salt and sugar consumption. You should exercise too but always discuss with your doctor before you start.”

For healthy people, Dr Chew says: “Maintain a healthy lifestyle that involves watching your diet, maintaining an ideal body weight, exercise regularly and don’t smoke.”

“If you practise healthy habits and lifestyle, the chances of developing high blood pressure, diabetes, and even heart diseases are lower. This helps to prevent heart failure too.”

If heart disease like coronary artery disease develops, Dr Chew advises: “Appropriate treatment and management of your condition can prevent the heart disease from getting worse, reduce heart attacks and prevent the heart from getting damaged and avoid heart failure.”

Some of the signs and symptoms of heart failure include shortness of breath or trouble breathing, fatigue and weakness, swelling (in the ankles, feet, legs, abdomen), rapid or irregular heartbeat and persistent cough or wheezing.

“Heart failure symptoms are not distinct and some of them are pretty common. That’s why it can be challenging to diagnose heart failure. For some heart failure patients, they think they are short of breath because they are not fit. But if you feel unwell, don’t dismiss it as ageing. Go get it checked, ” he says.


Atrial Fibrillation Potentially Lead To Life-threatening Complications

[Kuala Lumpur]

Do you often feel irregular heartbeat or a flip-flopping in your chest, and may even be accompanied by symptoms such as dizziness, chest tightness, and difficulty breathing?

Be careful, your heart “circuits” may be out of order, and you may have suffered from atrial fibrillation (AF) without knowing it. The coronary arteries are the main conduits for nutrition to the heart. The strong door wall is the heart’s various heart valves, and the heart wall is full of “circuits” like a house. The circuit of the heart is equivalent to our heartbeat. Normal and regular heartbeat only can ensure the normal and smooth operation of the heart’s “circuit”.

When the circuit is disordered or the heartbeat rhythm is abnormal, it will cause AF (also referred to as Atrial Fibrillation) is the most common arrhythmia in clinical practice.

Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Cardiologist and Cardiac Electrophysiology Specialist, Datuk Dr Razali Omar bluntly stated that many people have ignored the danger of atrial fibrillation: ” Decades ago, people did not pay much attention to the problem of atrial fibrillation, and even considered this disease as one of the ageing processes. However, advances in medicine and more global data show that atrial fibrillation is a dangerous disease, which may cause heart failure, stroke, and even death, and it also seriously affects the quality of life of patients.”

He urged the public to learn to measure the pulse at their wrists and learn to master the speed, the regularity, and the strength of their pulses. If they feel anything unusual or feel unwell, they should consult a doctor for further examination as soon as possible. In life, we should try to prevent or avoid the risk factors that cause atrial fibrillation. Besides, you can consider using mobile ECG, wear a mobile ECG monitor on your wrist to monitor your heart rhythm for a long time, clearly record it and provide it to the doctor during the consultation for more comprehensive evaluation and monitoring.

Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Cardiologist and Cardiac Electrophysiology Specialist, Datuk Dr Razali Omar believe that the public should pay attention to the risk of atrial fibrillation, early diagnosis with suitable treatment can help prevent serious complications such as stroke, heart failure, and eventually may help reduce the risk of death.

Datuk Dr Razali Omar: Treatment Delay May Worsen

Maybe you think that atrial fibrillation is nothing, just an irregular heartbeat, which is no big deal, but actually, you are wrong!

One of the greatest dangers of atrial fibrillation is stroke. In fact, stroke caused by atrial fibrillation is more harmful than a stroke caused by atherosclerosis such as hypertension. Under normal circumstances, our heart contraction and relaxation are coordinated, but when atrial fibrillation occurs, the blood in the atrium will stagnate and form a thrombus. This kind of thrombus from the atrium is often larger in size. Once the thrombus flow with blood enters the brain, the ​​brain tissue leads to necrosis, and it will cause serious consequences such as stroke or death. What’s more worrying is that atrial fibrillation is getting in the younger generation.

Datuk Dr Razali Omar said bluntly that there were not many patients with atrial fibrillation in clinical outpatient clinics in the past 20 or 30 years ago, and most of them were elderly patients. This pattern has changed in recent years, and recently more young people are facing atrial fibrillation and Its risk of complications.

Datuk Dr Razali Omar also pointed out that the actual incidence of atrial fibrillation may be higher than the statistics. The reason is that some patients have not obvious symptoms, so they have not received the proper diagnosis and treatment, especially young patients who are not aware that they may have atrial fibrillation problems: “This is a progressive disease. If it is not treated in time, it may worsen. Once it worsens, the episodes of atrial fibrillation will be more frequent and the duration of each episode will be longer. Therefore, immediate treatment is very important. If atrial fibrillation develops to be persistent or permanent, treatment becomes more difficult.”

Thrombosis must be prevented

Besides that, he emphasized that all treatments for atrial fibrillation require pre-assessment of the patient’s risk of stroke to further develop an appropriate treatment plan: “If the assessment shows that the patient’s risk of stroke is low, the focus can be on treating atrial fibrillation, but if confirmed patients have a higher risk of stroke, so they need to formulate a stroke prevention and management plan, start with anticoagulation therapy as soon as possible, and then decide the treatment plan for atrial fibrillation according to individual circumstances.”

In short, atrial fibrillation requires early diagnosis and early treatment. When formulating a treatment plan, the prevention of thrombus must not be ignored. Appropriate drugs or Catheter Ablation therapy must be taken according to the patient’s condition to control the heart rhythm and avoid irreversible strokes, heart failure, etc.

According to data from a study published by MedSpace, people aged 40 or above may have about a quarter probability of developing atrial fibrillation in their lifetime. The prevalence of atrial fibrillation is more closely related to the increase in diseases such as stroke and heart failure, and its incidence will increase with age. According to predictions, by 2050, atrial fibrillation will become one of the most popular cardiovascular diseases.

In another word, the harm of atrial fibrillation is manifold. Statistics show that atrial fibrillation may not only induce severe stroke (the risk of stroke increased by 5 times) and heart failure (the risk of heart failure increased by 3 times), the disability rate and fatal also extremely high. And it is also a heart disease that causes a huge burden on society and individuals!

Catheter ablation therapy is one of the most common and recognized treatment strategies that can effectively reduce the risk of triggering atrial fibrillation.

High success rate with early treatment

The main purpose of atrial fibrillation treatment is to try to restore normal sinus rhythm, control the ventricular heart rate within a relatively normal range, and prevent the formation of thrombosis. At present, the treatment of atrial fibrillation mainly includes drug therapy and non-drug therapy. Drug therapy mainly includes antiarrhythmic drug therapy and anticoagulant drug therapy, while non-drug therapy mainly includes: electrical cardioversion therapy (external electric shock), catheter ablation therapy and surgical treatment.

Catheter ablation therapy is one of the most common and recognized effective treatment strategies in recent years helps to reduce the risk of triggering atrial fibrillation. This is a minimally invasive interventional treatment. Through a tiny puncture in the groin, a catheter is sent into the atrium through a vein or artery to ablate the diseased cells, and necrosis the cardiomyocytes at the target site help to prevent the transmission of abnormal electrical signals. This can help to treat atrial fibrillation.

Catheter ablation surgery must be performed by a cardiologist (cardiac electrophysiology speciality) who specializes in arrhythmia examination and treatment, and it must also be performed in a dedicated cardiac catheterization laboratory (Cath-Lab). Patients usually need to receive local anaesthesia (injection of anaesthetic at the puncture site) and intravenous sedation.

In other words, atrial fibrillation is like a circuit problem in the house, which requires a professional cardiac “electrician” to treat it. Datuk Dr Razali Omar emphasized that the success rate and cure rate of atrial fibrillation diagnosed and correctly treated in the early stage are relatively higher!

Know more about Atrial Fibrillation

What is Atrial Fibrillation?

Atrial fibrillation is one of the most common arrhythmias in clinical practice, and its incidence increases with age. The human heart is divided into left and right atria and left and right ventricles. The sinoatrial node located in the upper right atrium will regularly send out pulse commands. After a short delay in the atrioventricular node, the electrical signal reaches the entire heart through the conduction system, causing the heart to produce synchronized and coordinated contractions. Every time an impulse occurs in the sinus node, the heartbeats once. It is called “sinus rhythm” in medicine. Sinus rhythm is one of the indicators of normal heart activity. The normal heart rate of the human body is rhythmically beating 60 to 100 times per minute. When atrial fibrillation occurs, the atrium loses its normal and effective contraction function and no longer beats regularly, but becomes irregularly trembling, with a frequency per minute. It may be as high as 300 to 600 times, in a state of rapid turbulence.


Atrial Fibrillation Classification

Atrial fibrillation is mainly classified according to the onset time of atrial fibrillation:

  • Paroxysmal atrial fibrillation

The onset of atrial fibrillation lasts within 7 days, mostly within 48 hours, and can return to sinus rhythm on its own.

  • Persistent atrial fibrillation

The attack of atrial fibrillation lasts more than 7 days and requires medication or an electric shock to convert to sinus rhythm.

  • Long-term persistent atrial fibrillation

Cannot terminate on its own or relapse after termination.

How is atrial fibrillation diagnosed?

The diagnosis of atrial fibrillation is mainly based on the ECG examination and clinical manifestations of the patient at the onset. Besides, to understand the cause of atrial fibrillation, or determine whether there are other complications and risk factors, the doctor may need to do some related tests, such as blood tests (check whether there are other conditions that may cause atrial fibrillation, such as abnormal thyroid function), X-ray imaging examination (to check whether the heart is enlarged or whether there is lung disease), 24-hour dynamic electrocardiogram (which can record the heart rhythm when symptoms appear, determine whether there is atrial fibrillation and the duration of atrial fibrillation), cardiac ultrasound examination (Check whether the structure and function of the heart valve are abnormal, whether there are blood clots in the heart, etc.), CT scan of the heart, etc.



Matters of the heart

[Nilai, Negeri Sembilan] NILAI Medical Centre (Nilai Medical) has launched its Your Heart Matters campaign, a 30-minute per day challenge to create awareness about the importance of exercising as part of a healthy lifestyle.

The 30-minute per day challenge comprises a variety of exercises suited to each individual’s preference – whether a 30-minute walk, run, jog or simple exercises such as squats or sit-ups.

The objective is to allow your body to be active and get your heart rate up.

“It is worrying that some of us neglect every possible way to improve our lifestyle. If food intake is not accompanied by any form of exercise, the excess energy is stored as fat in the body. Over time, we are only inviting unwanted complications to our bodies, thus affecting our overall health,” says Nilai Medical chief executive officer, Jasmine Lau.

By making a few changes to our lifestyle, we can reduce our risk of heart disease. It will also improve our quality of life and set a good example for the next generation.

Nilai Medical’s senior dietitian Soh Hui Fang says a healthy diet and lifestyle are our best weapons to fight heart disease. Whether we are looking to improve our heart health, have already been diagnosed with heart disease, or have high cholesterol or high blood pressure, there are healthy diet tips that can help us better manage heart conditions and lower our risk of a heart attack.

“A healthy meal pattern should include a variety of fruits and vegetables, whole grains, low-fat dairy products, fish and poultry, nuts and legumes, and healthy oils as well as drinking enough water,” says Soh.

Through this campaign, the hospital hopes to improve public knowledge of cardiovascular disease (CVD), drive prevention, diagnosis and control of CVD and most importantly, encourage fellow Malaysians to influence their family and loved ones to start making healthy choices too.

Nilai Medical recently collaborated with Cardiac Vascular Sentral Kuala Lumpur (CVSKL), one of Malaysia’s first private and integrated cardiac and vascular hospitals in the region, to assist in providing medical and surgical treatments including interventional cardiology services and cardiothoracic surgeries.


“Coronary heart diseases have long been the leading cause of death over the years, but we are also seeing patients who are younger with multiple risk factors and an increasing trend of complex cases,” says CVSKL chairman and cardiothoracic surgeon, Tan Sri Dr Yahya Awang.

Despite efforts to educate the public on modifiable risk factors, the rate of CVD continues to rise. The level of knowledge and awareness amongst the general public is alarmingly low.