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‘The average age when a heart attack occurs is 58, so anyone below 40 years is considered young,’ says Dr Al Fazir.

Knowing your risk factors is key to managing heart disease that is increasingly affecting younger people. ONLY in her early 30s, Lina (not her real name) booked an appointment with her doctor after experiencing shortness of breath. She gets tired especially from exertion and climbing up the stairs.

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.

What to look out for

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.

Early screening important

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).

Know your risk profile

Understanding your risk profile is important to manage your lifestyle and if you have risk factors to manage – which can be divided into modifiable and non-modifiable risks.

“Modifiable risk factors are obesity, blood pressure, sugar, cholesterol levels and lifestyle as well. Lifestyle means the amount of exercise you do if you lead a sedentary life, smoking, and consume excessive amounts of alcohol.”

The non-modifiable risk factors, he says, are those of genetics, sex and age.“Stress is another risk factor that is difficult to measure but can have an indirect effect on your modifiable risk factors. “If the parent has heart disease, the patient may inherit risk factors like diabetes and high cholesterol.”

Simple tasks such as climbing a flight of stairs which now makes you breathless can be an indication of heart disease.

Lifestyle for better heart

If you are diagnosed with coronary artery disease, there are actions you can and should embrace. “The first is to adopt a healthier lifestyle. This means exercising for at least 150 minutes a week, reducing dietary cholesterol and salt intake, and cutting out sugar completely if you can.

“It is a good trend that people are exercising regularly but you have to be careful as well because some people have not exercised for a while but they go and sign up for a marathon run. “While exercising is good, you should know what your target heart rate is and know how much to push your body,” says Dr Al Fazir.

He says that your personal physician will advise on these and may advocate important pillar medications if you suffer from diseases such as hypertension, high cholesterol and diabetes. He adds that with the ease of current social media, this can lead to misinformation on side effects and patients sometimes stop taking their medicine.

“Some patients with heart disease just stopped taking their medications because they received a message (from well-meaning friends and family or online). “Please be discerning about the information you received and check with your doctor if you have any concerns about your medication or treatments”


#BreakTheHeartAche is a public education campaign that focuses on driving awareness on heart diseases in Malaysia. Jointly organised by Cardiac Vascular Sentral Kuala Lumpur and Viatris Malaysia, this campaign highlights the importance of early detection of heart problems, and to seek relevant treatment.

For more information, go to

KKLIU no.: 3133/2022

Expiry: Dec 31, 2024