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[Kuala Lumpur]

It turns out that symptoms such as dyspnea or shortness of breath, wheezing, and tiredness are all symptoms commonly described by the most heart patients. Cardiac Vascular Sentral Kuala Lumpur (referred to as CVSKL) cardiologist, Dr. Lawrence Chan pointed out that when the heart has problems, patients often have symptoms of chest tightness and dyspnea: “Shortness of breath or dyspnea is a common symptom. Although asthma, lung disease, anemia, severe liver and kidney problems, and even coronary pneumonia may cause the above symptoms, it may also be attributed to heart function problems or even one of the early warning signs of heart failure.”

CVSKL Cardiologist Dr. Lawrence Chan pointed out that dyspnea is not necessarily a lung problem. In many cases, it may also be a heart problem or even one of the early warning signs of heart failure.

Dr. Lawrence Chan: Patients with chronic diseases are at high risk of having heart failure

Under normal circumstances, the heart pumps blood from the arteries to the whole body. Oxygenated blood is transported to the rest of the body and deoxygenated bloody will be pumped back to the heart through the veins. Therefore, the heart must contract and relax to ensure that blood circulation continues in an orderly manner.

Heart failure does not mean that the heart has stopped beating or has completely lost its function, but it means that the state of the heart is not as good as it used to be, and it can no longer do its job as efficiently. Generally speaking, heart failure usually refers to the failure of the heart to fill up with enough blood, or the inability to transport blood to all parts of the body. Heart failure is due to various causes of malfunction of the heart. In this case, the cardiac output will be reduced and is unable to meet the needs of various tissues and organs of the body, causing a series of clinical symptoms. Difficulty in breathing is one of them.

The so-called dyspnea or shortness of breath is simply a symptom of not being able to breathe in air and working harder than usual to breathe.

Of course, sometimes people may have difficulty breathing when exercising. How do we know when we need to see a doctor? According to Dr. Lawrence’s analysis, if you belong to a high-risk group (such as smoking, hypertension, diabetes and other chronic illness diseases) or dyspnea is accompanied by the following symptoms, it is best to consult a general practitioner or a cardiologist as soon as possible for further evaluation and diagnosis of:

  • Worsening symptoms of breathing difficulty
  • Chest tightness, chest pain, fainting, or nausea
  • Swollen ankles
CVSKL Cardiologist Dato’ Dr David Chew emphasized that heart failure can be treated. The correct treatment plan will help patients improve heart failure symptoms and heart function.

Dato’ Dr David Chew: Chronic high blood pressure can increase heart load.

Heart failure refers to the inability of the heart to pump enough blood to meet the needs of the body. It is also the final stage of the development of various cardiovascular diseases. Epidemiological data shows that more than 26 million people worldwide suffer from heart failure, and it can affect any age group. It is a disease with high morbidity and mortality.

According to the European Heart Journal in 2016, the onset of heart failure in European and American countries ranges from 70 to 75 years old. The average age of heart failure patients in Asian countries is 60 years old, and the condition is more severe than that in European and American countries. Coupled with high blood pressure, obesity (Malaysia is the country with the most obese population in Asia) and diabetes, these are common risk factors that lead to heart failure. Heart failure has become a health issue that you and I need urgent attention and prevention.

According to CVSKL Cardiologist Dato’ Dr David Chew, the main cause of heart failure is diseases that damage the heart, such as: dilated cardiomyopathy, hypertension, coronary heart disease and so on. “Dilated cardiomyopathy is a very common type of cardiomyopathy. Patients will present with symptoms as heart failure and enlarged heart. Once the heart is enlarged, the heart function will reduce. Genetics, and the presence of viral infection and inflammation are all possible causes to dilated cardiomyopathy. In addition, hypertension is also one of the main risk factors for heart failure.”


Good Control Blood Pressure Can Reduce Half of The Risk.

The cause of heart failure due to high blood pressure which will increase the load on the heart. The heart must contract more forcefully than normal to pump blood into the aorta to combat the elevated blood pressure. Eventually, the heart walls will thicken (hypertrophy) or become stiff, causing only less blood to be pumped out than normal with each contraction, which eventually leads to heart failure. Studies have shown that poor blood pressure control can lead to heart failure, and good blood pressure control and treatment can reduce the risk of heart failure by 50%!

During a consultation with cardiologist for breathing difficulties or any suspected symptoms, the doctor will usually first perform some tests to diagnose whether you have heart failure or other heart disease. In addition to the most basic enquiry about the patient’s medical history, physical examination, heart murmur examination, etc other examinations will also be carried out according to individual patient needs, including blood examination, chest X-ray examination, cardiac ultrasound examination, electrocardiogram examination, angiogram and so on.

In medicine, heart failure is mainly based on its development (acute and chronic), location (for example: left heart failure, right heart failure, and total heart failure), and basic principles (for example: systolic insufficiency and diastolic insufficiency) ) And the manifestations of heart failure (for example, there are no symptoms in the early stage, but the heart is enlarged and the heart function is reduced during the examination). Doctors will classify heart failure according to the patient’s symptoms, severity and various examination results, and different heart failure problems require different treatments.

Heart Failure Is Not the End of Life

In any case, even if the heart fails, life is not the end! Medically, heart failure can be divided into left heart failure, right heart failure and congestive heart failure. Left heart failure can be further divided into systolic heart failure with abnormal myocardial contraction and diastolic heart failure with abnormal myocardial relaxation. Different heart failure problems require different treatments.

Dato’ Dr David Chew emphasized that heart failure is a chronic disease. Various treatment options can be combined according to the different conditions of the patient to improve the symptoms of heart failure and heart function to help patients improve their quality of life: “Drugs are usually the main treatment for heart failure. Clinically applicable drugs include angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists (ACEI/ARB), β-receptor blockers and aldosterone receptor antagonists (MRA), according to different patient conditions Combination treatments prescribe drugs to help improve patients’ symptoms and maintain heart function.”

Follow the Doctor’s Advice to Control Heart Failure.

The main goal of drug treatment is to relieve symptoms, delay the deterioration of the disease and reduce the risk of death. To achieve the above-mentioned treatment goals, a variety of heart failure-related drugs are generally required. In some cases, as many as 5 drugs may be required. In the past, patients with heart failure often need to take multiple drugs at the same time. In recent years, more and more combination drugs with multiple effects have been developed to help improve patients’ compliance with medication.

In any case, heart failure requires long-term medication to control the disease. Therefore, it is extremely important to follow the instructions to take the medication as prescribed. Dr. Lawrence said that patients must not reduce or stop medication by themselves, nor can they change the dosage or frequency of medication without prior consultation. Adhering to medical advice and treatment can prolong and maintain their quality of life. Additionally, patients with heart failure must also change their bad habits and adjust their diet to avoid aggravating the heart load and worsening the problem.

It Is Treatable, Don’t Give Up

“Prevention is always better than cure! If you are a healthy person, please maintain good habits and exercise regularly, and don’t let heart disease creep up on you. If you are already a patient with chronic diseases such as diabetes, hypertension, etc., be sure to follow your doctor’s advice to treat and control your condition, reduce the risk of heart failure. If you suspect that you have been diagnosed with heart disease, don’t delay treatment!”

Dato’ Dr David Chew emphasized that heart failure is a treatable disease. Even if the disease progresses to a severe stage and the drugs cannot work effectively, it is possible to consider whether to implant a ventricular assist device (such as a pacemaker) or surgical treatment according to the patient’s condition (Such as heart transplantation) to extend the life of the patient.

Medical Dictionary

Echocardiograms Examination and Cardiac Ejection Fraction

The percentage of stroke volume to ventricular diastolic volume is called ejection fraction. 50% or more is the normal range, which is also one of the important indicators for judging the type of heart failure.

Cardiac ejection fraction can be determined by echocardiograms. This test can assess the structure and function of the heart, understand the size and contraction of the heart, determine the activity of the heart valves, and allow the doctor to measure the thickness and stiffness of the ventricular wall The degree and ejection fraction are used to determine whether there is heart failure.

The ejection fraction is related to the contractility of the heart muscle. The stronger the heart muscle contractility, the greater the output of the heart per stroke, and the greater the ejection fraction. Once heart failure occurs, the myocardial contractility is weakened, and the ejection fraction will decrease. The more severe the heart failure, the lower the ejection fraction.


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