了解您的风险因素是控制越来越多地影响年轻人的心脏病的关键。丽娜（化名）在 30 岁出头时因呼吸急促而预约了她的医生。她感到疲倦，尤其是在劳累和爬楼梯时。

Exercise stress test showed ECG changes and her doctor proceeded to conduct further examination. That’s when a heart CT scan found Lina had several heart blockages. Lina is among many younger people who have what used to be seen as a disease of the elderly. For cardiologist Dr Al Fazir Omar, the youngest patient he has treated in recent years was in his early 20s.

“Noticeable now is that younger patients are coming in with heart disease,” says the consultant at Cardiac Vascular Sentral Kuala Lumpur. It scares me that patients in their early to late 30s are coming in with heart blockage. “We see a trend of younger people presenting themselves with heart disease,” he says, adding that the average age when a heart attack in Malaysia occurs is 58, so anyone below 40 years is considered young.

需要注意什么

Also known as cardiovascular diseases (CVDs), heart disease is a disorder of the heart and blood vessels leading to coronary artery disease, heart valve disease or an impairment in the heart’s electrical system. Like in Lina’s case, heart disease may present itself in unassuming ways.

Dr Al Fazir says that symptoms may take many forms such as chest discomfort, difficulty in performing physical tasks, breathlessness, swelling of the leg and palpitation. “A classic symptom is chest pain or discomfort in your chest walls. You get this uncomfortable, heavy and pressing feeling in your chest – the centre or to the left of your chest.

“It can also radiate to your arm, back and jaw.” As for breathlessness and difficulty in performing physical tasks, Dr Al Fazir shares: “Patients would say they were able to climb two or three flights of stairs without stopping but now needed to stop after half a flight of stairs. “Another patient once said that he could cycle fast on an incline but started to experience difficulties. When he came in, we found that he had 90% blockage in his artery.

“Some complained of swelling of the leg. “Make sure you go for a check up to find out what is causing this – it could either be the heart or issues with other organs such as the kidney disease that is causing the leg swelling,” he says. Dr Al Fazir says he has also come across a common symptom, especially since the covid pandemic: palpitations. “Patients come in saying there is an extra beat or a missed beat. While this is normally quite benign, it warrants further tests such as checking the patient’s clinical history or conducting an ECG and echocardiogram. “Sometimes, it is recommended to use a Holter ECG to monitor at home for a few days. Some smartwatches are able to pick up irregular heartbeats, too,” he says.

早期筛查很重要

As the saying goes, prevention is better than cure. In this case, Dr Al Fazir extols the importance of early screening. “Malaysians tend to have a lot of risk factors. It is important to know your risk profile and heart screening enables you to be more aware of your health.

“Heart screening is recommended after you are in your 30s. If you have a very strong family history of premature heart disease, you may want to check up even before your 30s. “I treated a patient in her 40s who was a triathlete and her only risk factor was a slightly raised cholesterol level. When we did the stress test and followed by CT cardiac, unfortunately, it showed a high grade of artery narrowing of the main artery,” he says.

Health screening not only screens for persons with coronary artery disease. Many young patients that come for assessment are worried if they are suffering from heart disease or that their friend just suffered from heart disease and it is causing them some distress. So it is nice to inform them that after all the checks that they are well and should continue and resume their daily activities and physical exertions without too much worry. Recently I have been seeing some patients as they are preparing for their Ironman (Ironman is known for their triathlon event).

了解您的风险状况

了解您的风险状况对于管理您的生活方式以及您是否有需要管理的风险因素很重要——这些风险因素可分为可修改和不可修改的风险。

“可改变的风险因素包括肥胖、血压、糖分、胆固醇水平和生活方式。生活方式意味着如果你过着久坐不动的生活、吸烟和过量饮酒，你所做的运动量。”

他说，不可改变的风险因素是遗传、性别和年龄。 “如果父母有心脏病，患者可能会遗传糖尿病和高胆固醇等危险因素。”