THE STAR, SATURDAY 29 SEPTEMBER 2018

HEALTHY HEART

The rhythm of life

This World Heart Day, unshackle yourself from
the grips of cardiovascular diseases by choosing to
follow a healthier lifestyle.
2 Healthy Heart
Journey to a healthier tomorrow
By SRIMAYEE SEN SARMA
WHEN technology, research and
medical science come together,
visions become reality.
In 2008, D’Zhana Simmons, a
then 14-year old resident of South
Carolina, survived 118 days
without a heart. She was kept alive
with the help of a custom-built
pumping device until she received
a heart transplant.
A quick Internet search would
draw numerous and more recent
incidents of how new technologies
such as smartwatches and
heartbeat monitoring apps have
helped save lives by detecting
irregular heartbeats and sending
alerts in the nick of time.
Furthermore, the medical field
has made great inroads in
introducing inventions and new
procedures such as pacemakers,
heart transplantation surgeries and
isosorbide dinitrate that go a long
way in saving lives.
Supporting this claim is a report
titled Deaths from cardiovascular
disease increase globally while
mortality rates decrease published
on the website of the Institute
for Health Metrics and Evaluation,
which states that efforts to prevent
and treat cardiovascular diseases
appear to be working as the
rise in deaths is slower than
the overall growth of the
population.
However, preventing deaths by
heart ailments remains as elusive
as ever, with cardiovascular
diseases (CVDs) still reported as the
number one global killer.
Datuk Dr Azmee Mohd Ghazi,
consultant cardiologist and clinical
director for heart failure and heart
transplant at National Heart
Institute (IJN), points out, “This
high number of cardiovascular
patients is to be blamed on
lifestyle choices.
“The sedentary way of living,
with no exercise and an unhealthy
diet, is globally the biggest cause of
CVDs in people.”
Doctors, surgeons and
researchers worldwide must
continue their battle of finding
better ways to save as many
lives as possible from the grips
of CVDs.
The good news is that with
technology on their side, the future
of cardiology looks hopeful. The
latest assistive devices, medicines
and surgical procedures – the fruits
of years of hard work, research
and technology combined – are
getting us closer to detecting CVDs
New technology makes cardiovascular disease detection and treatment easier.
Fitness bands, smartwatches and apps are already used extensively to keep track of heart health.
at the very onset and providing
effective treatment.
Healthy Heart looks into some of
the recent breakthroughs and
ongoing research.
The sidekicks
Assistive devices such as loop
recorders, heart rate monitors
and automated implantable
cardioverter defibrillators have
been instrumental in the diagnosis,
treatment and maintenance of
cardiovascular health for years
now.
Nevertheless, with the changing
technological scenario, new
and more advanced assistive
medical devices are being
conceived, putting science fiction
to shame.
One of such new medical devices
that is commercially available
is the vein finder. Just as the
name suggests, this device uses
infrared radiation to locate and
map veins.
Finding a vein to draw blood or
give intravenous injections can be
stressful for both medical
caregivers and patients. It gets
especially problematic with babies
and small children whose veins are
even more difficult to track.
The introduction of the vein
finder is an end to this problem.
This hand-held device makes
drawing blood or giving
intravenous medications a walk in
the park.
Another invention is the
leadless pacemaker. According to
Dr Ahmad Nizar Jamaluddin,
consultant cardiologist at Ara
Damansara Medical Centre,
the leadless pacemaker is an
improvement over the traditional
pacemakers used for treating
arrhythmia.
He explains, “These new
pacemakers do not have any lead
or wires and can be placed directly
into the heart chamber.
“The biggest advantage of a
leadless pacemaker is its small size,
The medical field
has made great
inroads in introducing
inventions and new
procedures such as
pacemakers, heart
transplantation
surgeries and
isosorbide dinitrate
that go a long way in
saving lives.
which can be easily implanted with
the help of a catheter inserted
through a vein, without the need
for surgeries.”
Another advantage of going
leadless is that it significantly
minimises the risk of infection,
which was commonly caused by
the wires of a traditional
pacemaker.
A life-saving device that was
recently approved by the United
States Food and Drug
Administration is the covered
coronary stent.
Heart procedures carried out to
save lives can pose life-threatening
risks themselves, and one such
condition that may arise is acute
coronary artery perforation.
A rare complication arising from
a percutaneous coronary
intervention procedure (previously
known as angioplasty with stent),
coronary artery perforation is a
tear in the vessel wall that can lead
to blood leakage.
When inserted with the help of a
balloon catheter, the covered
coronary stent system can
effectively seal the tear while
letting the blood flow normally
THE STAR, SATURDAY 29 SEPTEMBER 2018
through it.
The device is first of its kind in
treating acute coronary artery
perforation and eliminates the
need for open-heart surgical
procedures.
The road to recovery
With advancements in
diagnostic and surgical procedures,
days of faulty diagnosis and high
risks of experiencing a stroke,
excessive bleeding or getting an
infection during a heart surgery
are behind us.
State-of-the-art minimally
invasive techniques are one such
area of advancement that has
reduced the risks of surgery for
numerous patients.
Dr John Chan, consultant
cardiothoracic surgeon at Cardiac
Vascular Sentral Kuala Lumpur
(CVSKL), shares, “Minimally
invasive techniques do not require
the patient to undergo an open-
heart surgery.
“Although expensive, minimally
invasive surgeries are ideal for
patients with health complications
that make conventional heart
surgery risky for them.”
Though not completely risk-free,
minimally invasive techniques are
safer than open-heart surgeries as
the chances of infections, blood
loss and getting a stroke are
significantly lower.
Below are a few recent
procedures practised globally that
are giving a new lease of life to
heart disease patients.
l Transcatheter aortic valve
replacement/implantation (TAVR/
TAVI) – This surgical procedure is
for treating aortic stenosis. Done by
inserting a catheter to replace the
aortic valve, this new minimally
invasive surgical method has
proven to be a boon for patients
who cannot undergo an open-heart
surgery.
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THE STAR, SATURDAY 29 SEPTEMBER 2018 3
4 Healthy Heart
Innovating hope in cardiology
> FROM PAGE 2
An alternative to the valve
replacement surgery is valve
repair. Dr Chan shares, “The option
of valve repair versus replacement
depends on a number of factors,
including age, medical history and
the condition of the patient’s aortic
valve.
“However, whenever possible,
repair is better than replacement
since with repair, you preserve the
heart function and there is usually
no need for taking lifelong blood-
thinning medications.”
He adds, “There are many valve-
repairing surgeries being done in
Malaysia, making the country one
of the best places for such a
procedure.”
l Transcatheter mitral valve
repair or mitral clipping – Dr
Azmee explains the need for this
procedure: “If you have heart
failure, sometimes you may
have a leaking valve caused by
enlargement of the heart, which is
known as mitral valve
regurgitation.”
A leaking mitral valve can flood
the lungs with blood, causing
congestive heart failure.
“To treat the leaking valve, we
have a procedure known as mitral
clipping where we implant a clip
into the heart with the help of a
catheter to reduce the leaking,”
adds Dr Azmee.
An alternative to the
conventional open-heart surgery
that is done to seal the leak, mitral
clipping is a minimally invasive
procedure that uses a clip that is
much like a clothes pin.
However, if the health of the
THE STAR, SATURDAY 29 SEPTEMBER 2018
patient permits it, surgeons still medications such as Entresto and under our control, such as age,
prefer to perform an open-heart
surgery. This is because mitral
Corlanor.
As Datuk Dr David Chew Soon
gender and family history – and
modifiable, which includes
Regardless of
clipping only reduces the leaking Ping, consultant cardiologist at smoking, obesity, diabetes, high the technological
advancements, we
whereas surgery can stop it CVSKL points out, “Although there cholesterol and high blood
completely. has not been any significant pressure.
l 3D mapping system – The
integration of 3D mapping with
progress in recent past in terms of
treating heart failure, the new
“While controlling the first two
modifiable factors depends on
cannot only rely on
catheter ablation has improved the medications have been successful personal discretion, the other risk researchers and
doctors to take care
diagnostic procedure for in lowering the mortality rates by factors can be regulated with the
arrhythmia. two-thirds.” help of medications.”
Dr Ahmad Nizar elucidates, “The
3D mapping system is much like
Omecamtiv mecarbil, a medicine
that is still being researched, is
Dr Shahrul Zuraidi Idris,
consultant interventional of our heart. We
the global positioning system. An
electrically sensitive catheter is
expected to take the battle against
this slow killer forward.
cardiologist and physician at
Columbia Asia Hospital – Klang,
need to do our part
inserted into the heart and the says, “In the recent ESC (European by making healthy
electrical signal it emits maps a 3D
image on the computer monitor.
Addressing the causes Society of Cardiology) Congress, the
topics often revolved around how lifestyle choices and
“This 3D mapping technique
can effectively point out the
One of the main reasons for
the increase in number of
to reduce our risk factors.”
According to him, there are
empowering others
origin of arrhythmia and is cardiovascular patients is the many breakthroughs in to do the same.
extensively used in lack of awareness. People take medications that address these
Malaysia for the their health for granted risk factors, including medication
purpose.” and visit a that reduces one’s sugar level
The US Food specialist significantly without having to “What is more important when
and Drug only when take insulin three or four times a it comes to saving patients’ lives is
Administration there are day. the quality of the specialists, and
recently approved a visible and “Then there is PCSK9 inhibitor Malaysia is on par with developed
cardiac 3D mapping clear medication, which can reduce countries in terms of providing
vest, which does symptoms. cholesterol and has been shown to high-quality and effective cardiac
not require any Even if reduce coronary artery disease as treatments.”
insertion of treatment well,” he adds. A lot of advancements are
catheters and is a is sought happening in the field of
completely non-
invasive procedure
early, the
fact
Playing our part cardiology and most hospitals in
Malaysia are equipped with the
for detecting remains that With such life-altering latest technologies to put this
arrhythmia. prevention is inventions already implemented or progress to practice.
better than on the way, heart disease patients However, regardless of the
Medications also play a cure. Hence, it is worldwide can breathe a sigh of technological advancements, we
pivotal role in treating important to relief. cannot only rely on researchers
cardiovascular address the risk Dr Azmee says, “Research and and doctors to take care of our
diseases. Heart factors to minimise the technology is an essential part of heart.
failure patients, possibility of CVDs. medical science, and technology We need to do our part by
for instance, Dr Ahmad Nizar shares, especially has become an intrinsic making healthy lifestyle choices
owe their “Biggest risk factors of CVDs can be part of diagnosing and treating and empowering others to do the
lives to new classified into non-modifiable – not cardiovascular diseases. same.
THE STAR, SATURDAY 29 SEPTEMBER 2018 5
6 Healthy Heart
Exercise to protect your well-being
ACCORDING to the World Heart Federation,
cardiovascular disease is responsible for 17.5
million deaths globally, making it the world’s
No.1 killer. By 2030, the figure is expected to
increase to 23 million.
Small lifestyle changes can make a
powerful difference in our heart health.
Exercising for 30 minutes a day, giving up
smoking and consuming a healthy diet can
help prevent heart disease and stroke.
In conjunction with this year’s World
Heart Day theme – My Heart, Your Heart –
Fitness Concept is committed to helping
people inspire each other into becoming
more heart-healthy with the Hybrid Trainer
Pro.
Start leading a healthy and active lifestyle
in the convenience and comfort of your
own home with Hybrid Trainer Pro by
ProForm.
The Hybrid Trainer Pro can switch
between a recumbent bike and cross trainer
for lower body toning or total body
endurance respectively by simply adjusting
the pedals and console. This two-in-one
machine not only saves space but also
money, making it a preferred choice for
home fitness.
The Hybrid Trainer Pro is equipped with
20 digital resistance levels that will take you
from beginner to advanced levels as you get
progressively stronger.
While exercising, maximise your workout
and keep track of your heart rate with the
EKG heart monitor.
The hybrid Trainer Pro's front-mounted
wheels allow you to conveniently move it
out of the way when not in use.
It has double functionality at half the price
with features such as:
l Two machines in one – This Hybrid
Trainer Pro offers comfort and variety for
low-impact workouts. Pedals can be easily
adjusted to accommodate a cross trainer or
Fitness Concept is offering its Healthy Heart Boost Package to encourage people to exercise and reduce their risk of developing heart disease.
bike position.
The specially integrated tablet holder
console is adjustable, so whether you
are sitting or standing, you can easily
monitor your workout on the large LCD
screen.
l Twenty smart workout applications –
Designed by a certified personal trainer, the
20 preset programs automatically adjust the
resistance of the cross trainer/recumbent
bike to maximise your exercise time for
quicker results.
The quick and easy navigation between
Learn a life-saving skill
applications makes it simple to select your
workout and get moving.
l Adjustable cushioned seat – With
the Hybrid Trainer Pro you are not just
working out, but also enjoying a comfortable
ride. The oversized seat has added
cushioning and is easily adjustable so that
you and your family members can find the
perfect fit for yourselves.
l Soft upper-body grips – Improve
muscle tone with the upper-body cross
trainer resistance arms that provide a
great total-body workout and increased
cardiovascular benefits.
Fitness Concept is offering its Healthy
Heart Boost Package, which includes the
Proform Hybrid Trainer Pro and Proform
Anti Burst Stayball with instalments of
RM140.34 per month over 24 months
(Peninsular Malaysia only).
DO you know how to react if you see
someone collapsing in front of you? What
would your first course of action be if the
person is not showing signs of breathing? Is
it a classic case of a heart attack and is it safe
to move the person?
These questions are important to consider
so you can be prepared should a medical
emergency unfold in front of you.
Knowing what to do in those crucial
moments can be the difference between
life and death for someone in medical
distress.
According to The Heart Foundation
of Malaysia, up to 30% of medically
certified deaths in government hospitals
are attributed to cardiovascular diseases.
From this total, some deaths occur outside
hospitals and within the first two hours
after the onset of symptoms.
Coupled with the fact that cardiovascular
diseases remain the leading cause of death
among Malaysians, it should be an issue that
everybody is aware about.
Sadly, this is not the case and many
Malaysians do not fully understand the
THE STAR, SATURDAY 29 SEPTEMBER 2018
With the Healthy Heart Boost Package,
grab free gifts such as squeeze balls,
a NordicTrack body fat/hydration
scale, Fitness Concept protective mat
and BP Healthcare health screening
vouchers.
Enjoy more deals from Fitness Concept
until Oct 31. The prices and promotions
above are subject to terms and conditions
and are only available while stocks
last.
Fitness Concept is Malaysia’s largest fitness
specialist chain as certified by The Malaysia
Book of Records with 45 outlets in leading
shopping malls nationwide.
n For more information, call 03-7726 7787
(IPC Shopping Centre store)/03-2282 3200
(Mid Valley Megamall store), e-mail
enquiries@fitnessconcept.com.my or visit
www.fitnessconcept.com.my
dangers of heart disease, its prevalence
or the various symptoms associated
with it.
While hospitals and non-governmental
organisations are taking steps to create
awareness, the public must do its part to be
informed not merely to spot possible cases of
heart attack or heart failure, but also equip
themselves with life-saving skills such as
cardiopulmonary resuscitation (CPR)
knowledge.
Learn how to respond
CPR is performed in emergency situations
when a person does not show signs of life or
the heart stops.
In the case of a heart attack, the victim’s
ventricle has lost its ability to beat in an
organised fashion and thus fails to pump
blood throughout the body.
The brain, which is the most sensitive part
of the human body, is affected within
seconds of the heart stopping.
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THE STAR, SATURDAY 29 SEPTEMBER 2018 7
8 Healthy Heart
Be more than a bystander
> FROM PAGE 6
The victim will lose consciousness
due to the lack of oxygen and brain
death will occur in less than 10
minutes.
CPR helps prolong circulatory
and lung function by restarting
oxygenated blood flow to the
heart and brain until the affected
person is able to receive medical
attention or defibrillation.
The sooner you perform
CPR on a person who has
experienced cardiopulmonary
arrest (where there is no sign of
breathing or a heartbeat), the
greater his chances of being
successfully resuscitated.
For this reason, it would be
ideal if everyone were to undergo
a CPR training programme through
initiatives such as the introduction
of CPR training in schools.
While there are ample resources
online that describe the step-by-
step process and show videos of
how to perform CPR, the procedure
is a taught skill and people need
to learn the proper techniques
because incorrectly performed
CPR can cause broken ribs and
bruising.
Among the topics usually
highlighted in a CPR course
such as those organised by The
Heart Foundation of Malaysia are:
l Coronary artery disease
l Risk factors for heart attack
l Lung anatomy and function
l Recognising a heart attack
l Recovery position
l Airway obstruction in conscious
and unconscious adults
l CPR and airway obstruction
in children and infants
One must undergo assessments,
including theory and skills tests,
before he is awarded a certificate
acknowledging his success in
completing the programme, after
which he may apply the skills he
learnt to emergency situations.
THE STAR, SATURDAY 29 SEPTEMBER 2018
Prevent heart
disease, plan
for better health
THE world number one killer
disease is heart-related disease.
Our country Malaysia is no
exception.
One important component
of heart disease refers to
coronary artery disease,
whereby plaque builds up
within the coronary arteries and
causes a multitude of problems,
including heart attack, heart
failure and more.
According to World Health
Organization, coronary artery
disease accounted for 98.9
deaths per 100,000 population
in Malaysia in 2012, or 29,400
deaths (20.1% of all deaths).
It is the most common cause
of deaths in the country.
A heart attack
What is a heart is the worst that
attack?
you can get from
A heart attack is the worst
that you can get from the build-
the build-up of
up of plaque. It occurs when plaque. It occurs
when blood supply
blood supply to part of the heart
muscle is severely reduced or
stopped.
This occurs when one of the to part of the
major arteries carrying blood
to the heart muscle is suddenly
heart muscle is
obstructed, usually by a severely reduced
combination of clots and fat.
When the blood supply is cut or stopped. This
off for a long period of time, the
heart muscle suffers irreversible
occurs when
injury and cells die. one of the major
This will result in disability
or even death, depending on arteries carrying
how much heart muscle is
damaged.
blood to the heart
muscle is suddenly
Coronary angiogram, obstructed,
angioplasty and bypass usually by a
surgery combination of
An angiogram is a type of
X-ray procedure that can be both clots and fat.
diagnostic and therapeutic. It is
the gold standard for evaluating Dr Noorfaizan Saaidin
blockages in the coronary
arterial system. analyse your eating habits.
A coronary angiogram is a If you see any bad habits, start
relatively minor procedure, changing them.
involving a local anaesthesia,
and serves to detect blockages l Get moving – Allocate
using X-rays taken during time to exercise at least two
the injection of a contrast agent. or three times a week, for a
It provides information that minimum of 15 to 30 minutes
helps cardiologists and cardiac each time.
surgeons determine the
treatment options. l Lose weight wisely –
Following an angiogram, a Weight loss of 0.5kg to 1kg a
treatment option for the patient week is safe. Eat 250 calories less
is to receive balloon and stenting per day to lose about 0.5kg in a
treatment to the severely week.
narrowed segment. This is called
coronary angioplasty. l Be active – Take a walk, jog,
However, if there are too swim, cycle or dance.
many blockages and too much
narrowing, and the patient is l Eat right – Cut down on
somehow deemed unsuitable sweets, fats and salt. Eat more
for coronary angioplasty, fruits, vegetables and whole
coronary artery bypass grafting grains. – By Dr Noorfaizan
(CABG) surgery will be Saaidin, consultant
recommended. cardiologist (interventional
During CABG, new routes and non-invasive) at
(conduit) around narrowed and KPJ Selangor Specialist
blocked arteries will be created, Hospital
allowing sufficient blood flow to
deliver oxygen and nutrients to n To learn more about
the heart muscle. heart-related diseases and
procedures, call 03-5543 1030
Steps to better health (SDU) or visit www.kpjselangor.
com
l Start now – Record and KKLIU No.1879/2018
THE STAR, SATURDAY 29 SEPTEMBER 2018
OUR lives are becoming
increasingly hectic, so it is
inevitable that we tend to neglect
our health.
Many Malaysians are unaware
of the fact that heart disease is a
top killer in the country.
According to the Department of
Statistics and Health Ministry,
heart disease accounts for 13.2%
of all deaths in Malaysia.
A major risk factor of heart
disease is high cholesterol.
Out with the bad,
in with the good
Our body requires cholesterol
for important functions such
as digesting food, building the
structure of cell membranes and
producing hormones.
However, when there is too
much cholesterol in the body,
health problems can occur.
There are two types of
cholesterol that can be found in
the body – low-density
lipoproteins (LDL) and high-
density lipoproteins (HDL).
LDL is known as the “bad”
cholesterol because it can build
up on artery walls, giving rise to
heart disease.
HDL is the “good” cholesterol.
It helps move LDL out of the
bloodstream, reducing the risk
of developing heart disease.
For adults, cholesterol level
readings of less than 200mg/dL
are desirable. A reading of
240mg/dL or above is considered
high and action should be taken
to lower it.
Consuming between 1.5g
and 2.4g of plant sterols daily
can help reduce LDL levels by
up to 10% without affecting
HDL.
Lower cholesterol
with plant sterols
Every 200ml of
Marigold HL Low
Fat Milk with Plant
Sterols contains
0.7g of plant
sterol esters. By
drinking at least two
glasses daily, your
cholesterol levels
can be maintained
within the healthy
range for a healthy
heart.
A natural solution
Plant sterols (phytosterols) are
a group of natural compounds
that are found in plants.
They have a structure that is
similar to cholesterol and can
mimic as well as compete with
cholesterol for absorption.
As a result, less cholesterol is
absorbed into the body.
When consumed in optimal
amounts and paired with a
balanced diet, plant sterols can
Healthy Heart 9
help lower cholesterol (especially
LDL) that can put your heart at
risk.
Plant sterols are found in
vegetable oils such as
sesame, canola, corn and
olive oil, with smaller
amounts found in nuts,
legumes, breads and cereal
grains.
The easiest way to obtain
the daily recommended
dose of plant sterols is to
drink two glasses of
Marigold HL Low Fat Milk
with Plant Sterols every day.
Enjoy the goodness
Marigold HL Low Fat Milk
with Plant Sterols is fortified
with nine essential nutrients
– vitamins A, B1, B3, B6, B12,
C, D3 and E and folic acid –
and has 52% more protein
and 36% more calcium
compared to regular milk.
Every 200ml of Marigold
HL Low Fat Milk with Plant
Sterols contains 0.7g of plant
sterol esters. By drinking at
least two glasses daily, your
cholesterol levels can be
maintained within the
healthy range for a healthy
heart.
n Look out for the advertisement Plant sterols can help reduce the amount of bad cholesterol in the
in this StarSpecial. body to prevent heart disease.
10 Healthy Heart
HEART failure is a serious heart
condition. As with many medical
conditions, misconceptions are
bound to happen. For example,
patients generally group heart
failure in the same category as
cardiac arrest.
However, it is not the same as
cardiac arrest – where the heart
stops suddenly without any
warning. Heart failure is due to
inability of the heart to pump
sufficiently to meet the needs of
the body.
Datuk Dr David Chew Soon Ping,
consultant cardiologist at Cardiac
Vascular Sentral Kuala Lumpur
Hospital (CVSKL), predicts that the
number of patients with heart
failure will continue to grow in the
coming years.
“As the country’s population
Better recovery odds with modern surgery
CARDIOTHORACIC surgery
pertains to procedures involving
the heart and blood vessels that
are connected to it as well as other
organs and structures in the chest
such as the lungs and chest wall.
Many people do not know
about the differences between
cardiothoracic and cardiovascular
surgery.
Dr John Chan, consultant
cardiothoracic surgeon at
Cardiac Vascular Sentral Kuala
Lumpur Hospital (CVSKL),
clears the confusion, saying,
“The terms ‘cardiothoracic’
and ‘cardiovascular’ are often
used interchangeably but a
cardiovascular surgeon will
not operate on other organs in
the thoracic region, unlike a
cardiothoracic surgeon.”
Dr Chan explains that
cardiothoracic surgeons perform
a diverse range of procedures. He
says, “The most common cardiac
surgery performed in Malaysia is
coronary artery bypass grafting,
which is used to treat patients
with severe coronary artery
disease.
“Other forms of cardiac surgery
include replacing or repairing
heart valves, treating aneurysms
(abnormal dilations) of the aorta
and removing tumours that
develop in or around the heart.
General thoracic diseases treated
by cardiothoracic surgeons
include lung cancer, chest tumours,
pneumothorax and severe sweaty
hands.
“Cardiothoracic surgery is a vast
discipline that covers diseases of
the heart and that range in
seriousness from life-threatening
to minor.
“There are some core surgeries
that all cardiothoracic surgeons
perform such as coronary
bypasses, valve replacements
and lung resections, but many
surgeons choose to specialise.
“For instance, some surgeons
When the heart fails
ages, we’ll be seeing more people
with heart failure as it is more
common in the elderly,” he says,
adding that the increasing
incidence of hypertension,
diabetes, obesity and heart disease
will also contribute to a higher
number of people suffering from
heart failure.
The most common cause of heart
failure is coronary artery blockage.
Often, this blockage causes heart
attacks, which damage the heart,
causing heart failure.
Another common cause of
heart failure is high blood
Cardiothoracic surgeons treat diseases that affect the heart and other parts of the thoracic region.
choose to specialise in valve repair
or aortic surgery while others
may be more interested in treating
lung cancer.”
Catch it early
The diagnostic procedures for
cardiac diseases have become
more effective thanks to
advancements in medical
technology. Patients need to
identify certain symptoms first
before undergoing diagnostic
check-ups.
However, symptoms are not
always apparent. Dr Chan warns,
“Some patients have symptoms
such as chest pain and shortness
of breath, but many patients,
especially people with diabetes,
obesity and high cholesterol
who are more likely to develop
severe coronary disease, do not
have any symptoms and seem
completely well.
pressure. “The heart has to
work against higher pressure.
If the blood pressure is not
controlled for some time, it can
affect the heart function,” says
Dr Chew.
In some patients, the heart
muscle becomes weak without any
identifiable cause.
Symptoms of heart failure
such as breathlessness, swelling
of the legs or abdomen or
unexplained tiredness should
prompt a person to seek medical
attention.
Doctors usually assess the
heart by performing an
electrocardiogram (ECG) and
a chest X-ray to see if there
are any indicators of heart
disease.
Further specialised tests
can be performed, such as an
echocardiogram, angiogram and
cardiac MRI. These can be used
to confirm that there is heart
failure and assess for coronary
artery blockages as a possible
cause.
When heart failure is diagnosed,
different treatments can be
administered depending on the
level of severity.
There has been much research
and development for ways to treat
heart failure.
This has resulted in various
effective medications being used,
"Such patients should consider
attending regular check-ups to
ensure heart health.
“Diagnostic procedures for
heart disease include taking
electrocardiogram readings
when a patient is at rest and
while walking on a treadmill for
a certain period.
“If the reading shows any
abnormality, the patient will
need to go for further tests
such as a computed tomography
cardiac scan or coronary
angiogram, the second of which
is more invasive.”
Depending on the kind of heart
disease he or she has, the patient
may have to undergo treatment
through medication, coronary
stents or heart surgery.
Even though the field of
medical science has seen
immense progress over the years,
any kind of surgery – especially
heart surgery – still scares
THE STAR, SATURDAY 29 SEPTEMBER 2018
The most
common cause
of heart failure is
coronary artery
blockage in the
blood vessels.
Often, this blockage
causes heart
attacks, which
which can improve patients’ heart damage the heart,
failure conditions.
Dr Chew explains that most
causing heart
patients with heart failure can be
treated with medications, but he is
failure.
quick to point out that those who Datuk Dr David Chew Soon Ping
have responded positively to
treatment cannot be complacent as
they are not necessarily out of the donors and cost.
woods. As a final piece of advice, Dr
In some patients with more Chew reinforces the importance of
severe heart failure, medical prevention of heart disease by
devices such as specialised having a healthy diet and lifestyle.
pacemakers or an implantable In addition, if a person develops
cardioverter defibrillator can be heart failure, it is important to
considered. have it diagnosed and treated
In advanced heart failure, the promptly.
option of heart transplants or
implantable artificial hearts can be n For more information,
explored but is limited by lack of call 03-2276 7000.
Cardiothoracic
surgery is a vast
discipline that
covers diseases
most people. of the heart and
chest ranging in
Addressing this fear, Dr Chan
says, “Heart surgery has become a
lot safer these days with advances
in surgical techniques and post- seriousness from
operative care.
“In most routine coronary
life-threatening to
bypass and heart valve repair minor.
surgeries, for example, a patient’s
chance of survival is 99% while the Dr John Chan
risk of infection, stroke or organ
dysfunction is less than 1%.
“As is the case with most heart opines that the country has skilled
procedures, patients can resume specialists and up-to-date
normal habits within a few equipment.
weeks. He cites an example of how
“However, depending on the heart surgery has become
kind of cardiac surgery the patient extremely advanced over the
has undergone, surgeons will years, so much so that patients
instruct patients to follow certain who undergo procedures such as
precautionary steps.” valve repair surgery have the same
Although he believes that the life expectancy as an average
number of facilities in the country healthy person.
is not enough to cater to the
growing number of cardiothoracic n For more information,
patients in Malaysia, Dr Chan call 03-2276 7000.
THE STAR, SATURDAY 29 SEPTEMBER 2018
A man experiencing difficulty
breathing while having his palm
on his chest and in obvious pain is
the classic image one may associate
with a heart attack or heart
disease.
While the scenario is indeed
possible, Dr Shahrul Zuraidi Idris,
consultant interventional
cardiologist and physician at
Columbia Asia Hospital – Klang,
reveals that there is more to heart
attacks than excruciating chest
pains.
“The most classic signs of a heart
attack, especially among males, are
a central crushing pain, feeling of
pressure around the chest, and
pain radiating towards the arm or
jaw.
“Females can have atypical
symptoms. The nature of their pain
or discomfort may vary from
males, including an electrical
sensation, pins and needles,
giddiness, neck pain, and
numbness on the arm without
any chest pain at all.”
In addition, a significant number
of people who have diabetes can
develop “silent angina” or “silent
heart attack” where they can have
coronary artery blockage without
any chest pain symptoms.
As the signs of heart disease or
a heart attack are diverse, Dr
Shahrul warns not to be fooled
by the various types of pain or
downplay the seriousness of
these symptoms. A greater danger
is when people live in denial
about the possibility of having
heart diseases due to age or
lifestyle.
He says, “Nowadays, people of
the younger generation also get
heart attacks. In my years of
practice, the youngest heart attack
patient I have treated was 15 years
of age.
More than just chest pains
Regardless of your age and lifestyle, it is crucial to always be mindful of the
various risk factors associated with a heart attack.
“Sometimes, people are in denial
about heart issues because they
play sports and believe they do not
have a problem, but there are
people who died while playing
sports because they may have
experienced pain in the past yet
did not turn to a medical
professional to investigate.”
For this reason, Dr Shahrul
believes it is best to investigate for
heart issues than to live in
oblivion.
He recommends taking extra
precaution and going for a heart
check-up should individuals ever
feel any kind of pain around the
central chest area as it could be a
turning point in life.
As heart disease is a chronic
condition, patients may require
long-term treatment and incur
huge financial costs should they
fail to receive early diagnosis and
treatment.
The unfortunate reality,
however, is that females tend
to only consult a doctor or
cardiologist at a later stage because
they are not aware of the subtle
and atypical signs to look out for.
People should thus be concerned
with the various risk factors
associated with heart disease,
which include smoking, family
history of heart disease, diabetes,
hypertension, high cholesterol, lack
of exercise and high daily stress
levels.
Regarding people who may have
heart disease even if they lead an
active lifestyle, Dr Shahrul says,
“When you talk about sports or
exercise, you are only talking about
reducing one risk factor. It is never
mentioned that if you do a lot of
sports, your blood pressure,
cholesterol and sugar levels will
always be low. Addressing only one
risk factor may not be enough.
“Heart disease affects everyone.
There are modifiable and
non-modifiable risks. Hence,
doctors stress the importance of
undergoing health screenings,
especially for people over the age
of 40.”
According to him, most
prolonged and severe chest pain
should be treated seriously unless
proven harmless by medical tests,
be they an electrocardiogram
(electrical conduction of the heart),
echocardiogram (ultrasound of the
heart), blood tests, stress test or
coronary angiogram.
He points out that even if a chest
Healthy Heart 11
Sometimes,
people are in denial
about heart issues
because they play
sports and believe
they do not have a
problem, but there
are people who died
while playing sports
because they may
have experienced
pain in the past yet
did not turn to a
medical professional
to investigate.
Dr Shahrul Zuraidi Idris
pain sympton was not caused by a
heart attack, other conditions that
require immediate medical
attention are aortic dissection (the
tearing or bursting of the aorta
wall), perforated stomach (gastritis
due to ulcer), pneumothorax
(where the lung covering gets in
contact with air) and pulmonary
embolism (blood clot in lung
tissues).
n For more information, call
03-3346 7999.
12 Healthy Heart THE STAR, SATURDAY 29 SEPTEMBER 2018

Taking advantage of technology Familiarise

ACCORDING to Malaysia’s Statistics
Department, ischaemic heart
disease was the principal cause of
death among Malaysians in 2016, at
13.2%.
Also known as coronary artery
disease or coronary heart disease,
the condition occurs when
coronary arteries become
narrowed due to the gradual
build-up of fatty material such as
cholesterol and plaque within its
walls, resulting in decreased blood
flow through the arteries.
This in turn stops the heart from
getting the optimal amount of blood
and oxygen it needs, which can
ultimately lead to a heart attack.
The high number of Malaysians
succumbing to heart problems
highlights that there is still a
greater need for the public to be
conscious of their heart health and
go for regular health assessments
and heart screenings.
According to Subang Jaya
Medical Centre’s consultant
cardiologist Datuk Dr Yap Lok Bin,
among the factors that are stopping
people from undergoing heart
screenings is the fear of radiation
discharged by medical equipment.
However, he assures that there is
nothing to worry about as there
have been countless technological
advancements across the medical
industry, and the use of the latest
medical equipment such as 256-
slice computed tomography (CT)
scanners by many hospitals allows
for simple processes such as heart
screenings to become much
simpler, quicker and more
accurate.
“Classically, patients are always
worried about radiation, but the
industry has adopted scanners that
emit very low levels of radiation
The red circle indicates a calcified lesion forming a blockage in one of the
coronary arteries.
during screenings. It is said that the
amount of radiation emitted during
a calcium score test with the latest
CT machines is equivalent to only
two X-rays.
“New CT scanners can also take
more accurate and defined pictures
of the arteries. Moreover, a CT scan
is a non-invasive test, unlike a
coronary angiogram where doctors
would have to put tubes in the
body.
“The latest technology is very
fast, has very low radiation and is a
good way forward for patients
being screened for coronary artery
disease. CT scanners are no longer
limited to diagnostic purposes but
can also be used for screening
purposes,” says Dr Yap.
The danger of coronary artery
disease is that blockage in the
arteries is built gradually over time.
Patients may not know there is
anything wrong with their heart as
the disease may not show obvious
symptoms. The public must thus be
fully aware of the risk factors of the
disease, including diabetes, a
lifestyle that includes heavy
smoking and alcohol, and family
history – immediate family
members with heart conditions.
As coronary artery disease is
more prevalent in males and there
have been cases of the disease
among patients as young as 30
years old, Dr Yap suggests that it
would be wise for male adults to
consider going for a cardiac
calcium scoring test even before
they reach middle age.
The cardiac calcium scoring test
is a non-invasive CT scan
performed by CT technologists or
radiologists to measure the amount
of calcified plaque in the coronary
arteries. The test can be completed
within minutes and the results offer
a more accurate predictor of
coronary blockages compared to
cholesterol screening and other risk
factors.
Dr Yap says, “The calcium score is
likely to be zero for people below
the age of 30, which means the
likelihood of getting coronary
artery disease is very low at less
than 5%.
“A full CT scan or other types of
the dangers
Heart diseases are
associated with many
risk factors. How do
these risk factors
contribute to the
deterioration of heart
health?
l Diabetes – High
levels of glucose in the
blood weaken blood
vessels and the nerves
controlling the pumping
of the heart.
Over time, the
weakened blood vessels
clog up and nerves
become damaged,
leading to heart disease.
Datuk Dr Yap Lok Bin. l High cholesterol –
Too much cholesterol or
evaluation are only necessary having a high level of
when the calcium score is elevated, low-density lipoprotein
and you will then need to see a (bad cholesterol) and low
cardiologist. The discussion for level of high-density
the need of coronary angiogram lipoprotein (good
and angioplasty happens if there cholesterol) leads to
is a discovery of a blockage or plaque build-up in the
stenosis.” walls of the arteries,
Despite the availability of such causing them to narrow.
modern and advanced equipment The blood flow to the
in many hospitals across the heart is disrupted due to
country, the unfortunate truth is this clogging and blood
that a large number of the clots in the arteries,
population is not going for regular leading to a heart attack.
health and heart assessments – a l High blood
reality that has to change for the pressure – The heart
better. Dr Yap summarises, “If you must work harder to
have never had any test, then there pump against the
is always the chance that a heart increased pressure in the
attack may occur, and blood vessels, leading to
unfortunately, heart attacks come thickening of the heart
in all forms and shapes.” muscles and heart failure
He adds that with the severity of in the long term.
a heart attack varying between High blood pressure
cases, there is the possibility that also weakens the arteries
one’s encounter may lead to fatality. in the body, causing
clogging and blood clots
n For more information, call that lead to an increased
03-5639 1212. risk of stroke.
The raised pressure

Making sure the rhythm is right

WHEN you exercise or get excited
or scared, do you feel your heart
beat faster? It beats at a certain rate
and rhythm, which can sometimes
be disrupted.
“A normal heartbeat has a rate
and rhythm and is naturally
triggered by external stimuli such
as running or excitement,” explains
Dr Ahmad Nizar Jamaluddin,
consultant cardiologist at Ara
Damansara Medical Centre.
“However, if you experience an
inappropriate increase in heart rate
or irregular heart rhythm
accompanied by other symptoms
such as chest pain, dizziness and
blackouts, there is cause for
concern because if left unattended,
it may herald sudden death.”
This inappropriate and unusual
heart rate or rhythm is a medical
issue known as arrhythmia or
dysrhythmia. This condition can
occur in four ways:
l Tachycardia or abnormally
rapid heartbeat
l Bradycardia or abnormally
slow heartbeat
l Fibrillation or irregular
heartbeat (most common)
l Premature contractions or
early heartbeats
“There may be an underlying
cause of abnormal heartbeat or it
can be a primary condition such as
a primary electrical disease of the
heart. The heart is a biological
muscular pump driven by a
naturally occurring pacemaker and
electrical circuit. When there is a
problem with this pacemaker and
circuit, it can cause abnormal heart
rhythm,” he says.
Since arrhythmia is so closely
related to sudden death, people
with risk factors such as diabetes,
high cholesterol, obesity and a
family history of sudden
unexpected deaths should take note
of other accompanying symptoms
and get diagnosed immediately.
For proper treatment, finding out
the location of origin of the
arrhythmia is crucial because
arrhythmia originating from the
lower chambers of the heart
(ventricular tachycardia) is more
dangerous than arrhythmia
originating from the upper
chambers (supraventricular
tachycardia) as it translates to
higher risk of fatality.
“The first step in diagnosing this
problem is to detect the abnormal
rhythm and identify its location of
origin, and the best way to do it is
through an electrocardiogram
(ECG).
“However, the problem with ECG
is that it is much like an instant
picture and arrhythmia is not
usually a continuous occurrence.
If an ECG result is insufficient to
diagnose the abnormal heartbeat,
the next step would be to observe
the rhythm through an extended
ECG recorder such as a 24-hour
ambulatory ECG recorder (Holter
recording) or, if it is inadequate, an
implantable loop recorder,” says Dr
Ahmad Nizar.
An electrophysiology (EP) study is
the next step in the diagnostic
procedure. It is a proactive test and
is done to stimulate arrhythmias
and better understand the
Dr Ahmad Nizar Jamaluddin.
underlying mechanism of the
arrhythmia.
Dr Ahmad Nizar explains, “An EP
study is an invasive test, during
which catheters are inserted into
specific sites in the heart. The
conduction system of the heart is
studied and the abnormal heart
rhythm is induced either
electrically or with medication.”
According to him, 90% of
arrhythmia cases are caused by
dysfunctional circuits and an EP
study is the best diagnostic
procedure to find out the
mechanism and location of
origin.
The treatment for arrhythmia
would depend on the diagnosis of
the underlying cause and the type
and mechanism of the arrhythmia.
Usually, symptomatic, slow heart
rates known as bradycardia can be
resolved with a permanent
pacemaker implant.
On the other hand, rapid heart
rates and abnormal rhythms
including premature contractions
are treated with catheter ablation,
implantable defibrillators or heart
surgery. The most common cause of
ventricular tachycardias is still
coronary artery disease and heart
attacks.
About half the people who suffer
a heart attack succumb to
ventricular tachycardia and sudden
death. Some of those who survive
their heart attacks are still at risk of
sudden death because of the
damage to their hearts.
These conditions are sometimes
resolved through surgical
procedures to treat coronary artery
blockages, but the majority of those
at risk will require an implantable
defibrillator.
People often attribute sudden
death to a heart attack when it
could very well have been caused
by an inherited form of cardiac
arrhythmia.
“Fainting spells, fits and even
instances of drowning or sudden
deaths in your family history can
point to cardiac arrhythmia and
should not be ignored,” warns Dr
Ahmad Nizar.
Hence, even if you lead a healthy
life, it does not guarantee that your
heart is free of disease. The only
way to stay safe is to get diagnosed
early by attending regular check-
ups, especially if you notice
symptoms or are considered
particularly at risk.
n For more information, call
03-5639 1212.
may even cause the
arteries in the brain
to rupture, leading to
bleeding in the brain –
another type of stroke.
l Obesity – Being
overweight or obese
results in excess cardiac
workload or immense
pressure on the heart.
Obesity causes enlarged
hearts and thickening of
the heart muscles, which
can lead to heart failure.
l Smoking – As
carbon monoxide inhaled
from smoking reduces
the volume of oxygen in
the blood, the heart must
work harder to pump the
necessary oxygen to all
the organs in your body.
Your heartbeat also
increases with smoking
due to nicotine
stimulating the
production of adrenaline,
which can lead to
increased pressure on the
heart. Additionally,
smoking damages the
arteries and causes
clogging that can lead to
a heart attack or stroke.
l Family history –
Unfortunately, some
people carry genes that
make them more
susceptible to conditions
such as high cholesterol,
high blood pressure and
diabetes.
If you have any of these
risk factors, be sure to
take the necessary
precautions and go for a
heart check-up regularly
for peace of mind.
THE STAR, SATURDAY 29 SEPTEMBER 2018 Healthy Heart 13

UBIQUINOL is the converted
(reduced), active form of
Coenzyme Q10 (CoQ10), which is
naturally produced by our body.
Ubiquinol is an essential
nutrient for cellular energy
production and antioxidant
protection.
In a healthy adult, 90% or
more of the total CoQ10 in the
body is in the ubiquinol form.
Body tissue that has high
energy requirements and
metabolic rates such as the heart
and skeletal muscle contains
relatively high concentration of
ubiquinol.
What is the difference
between CoQ10 and
ubiquinol?
What is ubiquinol?
and energy levels cannot be
sustained. Thus, both are critical
to sustaining your body’s natural
energy.
Ubiquinol is simply the fully
reduced state or the unoxidised
form of CoQ10, which the human
body can immediately and more
easily use for energy.
Ubiquinol, being in its reduced
state, also provides antioxidant
function, protecting cells from
free radical damage.
Why Vitamode CoQ10
ubiquinol?
individuals. Absorption of dietary
CoQ10 is slow and very limited due
to its hydrophobicity and large
molecular weight.
Therefore, supplementation
products are required for those
whose CoQ10 levels are being
compromised.
Because ubiquinol is pre-
converted, it is ready for immediate
use by the body, making it suitable
for those unable to efficiently reduce
CoQ10 in the body.
What can Vitamode CoQ10
Ubiquinol do for you?
l Protects the body’s cells from
damage caused by oxidative stress
and free radicals
l Naturally regenerates other
antioxidants such as vitamin A
and E
How much Vitamode CoQ10
Ubiquinol should I take?
The recommended daily dose
of ubiquinol varies based on each
individual’s specific needs.
As a general guideline, start
supplementing with 200mg per day
for the first two to three weeks.
is highly absorbable and
is clinically tested to
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ubiquinol.
It is formulated using Kaneka
QH Ubiquinol, which is a bio-
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nutritional ingredient.
It is 100% made through yeast
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It is manufactured to stringent
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conforms to stringent USP
specification for purity, quality and
structure.

CoQ10 is sometimes referred
to as ubiquinone. Ubiquinone
and ubiquinol are both forms of
CoQ10 necessary to produce
cellular energy.
To generate cellular energy,
the body must convert
ubiquinone (inactive) into
ubiquinol (active).
Without this conversion, the
body’s energy production
process cannot be completed
Our body’s ability to produce
CoQ10 and convert it into
ubiquinol significantly depletes
as we age.
Without proper levels of these
vital substances, the body
produces less energy and lacks
strong defence against oxidative
stress.
Ubiquinol levels have been
shown to be suppressed in older
Energy
l Provides sustained, healthy
energy
l It is a key component in 95% of
the body’s energy production
Antioxidant
l It is a lipid-soluble antioxidant
After that, 100mg per day is a
good amount to maintain optimal
ubiquinol levels.
About Vitamode CoQ10
Ubiquinol
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This article is brought to you by
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Vitamode CoQ10 Ubiquinol is available in selected clinics and

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Spotting the
symptoms
THE number one killer
concerning diseases and health-
related issues is coronary heart
disease. According to World
Health Organization, in 2012,
about 29,400 deaths in Malaysia
were a result of coronary heart
disease.
Termed a “silent killer”, a
heart attack can strike a person
when he least expects it. Spotting
the signs of a heart attack could
save lives.
Dr Mahmood Sabruddin,
consultant physician and
interventional cardiologist at Dr Mahmood Sabruddin.
Avisena Specialist Hospital, sheds
some light on the symptoms. Prevention is better
“The symptoms of a heart
attack can vary. Typically, they
than cure
are chest pains described as While men are commonly at a
heaviness or tightness in the higher risk, Dr Mahmood shares
centre of the chest. that it is essential for females to
“This is associated with be wary of this disease too.
sweating, cold sweats and “The youngest female heart
numbness down the left arm,” attack patient I had was a
says Dr Mahmood. 32-year-old mother who didn’t
According to him, one may even know she was diabetic
experience symptoms of angina, as she never went for a check-
which is caused by reduced up.”
blood flow to the heart. He adds that with today’s busy
When this happens, your body lifestyle, it is important to
might experience any of the incorporate regular exercise,
following symptoms: enough sleep, proper nutrition
l Chest pains and annual health screenings
l Shortness of breath into one’s life.
l Palpitations
l Reduced effort n Look out for the advertisement
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14 Healthy Heart THE STAR, SATURDAY 29 SEPTEMBER 2018

Maintaining good
IN recent years, incidences of non-
communicable diseases (NCDs) such as heart
disease in Malaysia have been on the rise.
The dominant risk factors of chronic NCDs

health the natural way

are high blood cholesterol level, diabetes,
hypertension and obesity.
According to the National Health and
Morbidity Survey 2015, 9.6 million
Malaysians have high cholesterol level, 3.5
million have diabetes, 6.1 million are
afflicted with hypertension and 3.3 million
are obese.
It is estimated that the prevalence of these
risk factors will continue to increase. This
is a worrying trend for the country as
many seem to remain oblivious to the truth
and continue to indulge in unhealthy
lifestyles.
Many researches have proven that a slight
modification in one’s daily diet with the
inclusion of high-fibre foods such as oat
bran, which contains cholesterol-lowering
oat beta-glucans, is one of the most natural
ways of managing high blood cholesterol
level.
Oat beta-glucan is a soluble form of
dietary fibre that produces a cholesterol-
lowering effect due to its high viscosity.
It dissolves inside the digestive tract
where it forms a thick gel in the small
intestine.
This viscous “net” traps cholesterol and
cholesterol-related particles (bile acids) and
prevents them from being absorbed into the
bloodstream. They are then harmlessly
eliminated from the body.
When the liver subsequently produces
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THE STAR, SATURDAY 29 SEPTEMBER 2018
Eat to stay fit
FOOD is our main source of energy and
nutrition, and eating the right kind of food
could help you lead a long, healthy life.
Every organ in the body has its own set of
nutritional needs, and the heart is no
exception.
While nutrition is still an evolving branch
of science, there are certain foods that have
been proven to contribute positively to
DARK CHOCOLATE
We were warned as children to not eat too much
chocolate because it can be bad for our teeth.
Some dark chocolate, however, can be good for
heart health. Epidemiological and clinical results from
a 2015 study titled Cardiovascular Benefits of Dark
Chocolate? published in Current Treatment Options in
Cardiovascular Medicine suggest that the flavonols in
dark chocolate can have beneficial effects on blood
pressure and inflammation.
NUTS
You must be nuts if you don’t want
nuts in your diet. Nuts such as cashews,
almonds, pecans and walnuts have
high contents of “good” fat such as
omega-3 fatty acids that help reduce
levels of “bad” cholesterol or low-
density lipoprotein (LDL) in your
blood and keep your heart healthy.
SEEDS
Containing the highest amount of omega-3 fatty acids among all plant-based foods,
chia seeds are loaded with antioxidants, soluble fibres, magnesium, protein, iron and
calcium. Flaxseed and hempseed are also great sources of heart-healthy nutrients.
POTATOES
A common misconception is that potatoes
are high in calories. This superfood, which
comes in varieties such as sweet, white,
purple and red, is rich in fibre, calcium,
potassium and folic acid. To get the full
health benefit of potatoes, eat them with the
skin on.
FISH
Healthy Heart 15
BERRIES
Rich in antioxidants, members
of this fruit family such as
strawberries, blueberries, acai
heart health.
For example, foods high in omega-3 berries and goji berries can help
fatty acids have been proven to lower your body fight against oxidative
triglyceride levels in the blood, according to stress.
the American Heart Association. Too much
triglycerides in your blood can be bad for
your heart.
The following are some food items that
are rich in heart-healthy nutrients.
OLIVE
OIL
Doctors keep telling you to avoid oily
food to maintain heart health, but with oil
being such a large part of our diets, it is
difficult to give up completely.
Choose a healthier option instead such
as olive oil. Packed with antioxidants and
AVOCADOS monounsaturated fatty acids, olive oil can
reduce inflammation as well as LDL to
keep your heart happy.
Make it a habit of eating this fruit
regularly as it has been demonstrated that
avocados have beneficial effects on
cardiometabolic risk factors, according to a
2015 study titled Effect of a Moderate Fat
GREEN TEA The famous quote by ancient Chinese
philosopher Lao Tzu, “Tea is the elixir of
Diet With and Without Avocados on life”, rings truer than ever with green tea
Lipoprotein Particle Number, Size and proving to be effective in preventing
Subclasses in Overweight and Obese Adults: heart disease. Laden with antioxidants
A Randomized, Controlled Trial published such as polyphenols and catechins, green
in Journal of the American Heart tea can thwart cell damage and protect
Association. the heart in the process, suggests a 2007
study titled Effects of green tea and EGCG
on cardiovascular and metabolic health
published in Journal of the American
College of Nutrition.
Good news for all seafood
lovers! Fish, especially those of the
fatty variety such as salmon,
sardine, herring and trout, are
rich in omega-3. Eating three or
more servings per week can
reduce your risk of developing
heart disease as suggested by a
2003 study titled Cardiac benefits
of fish consumption may depend on
the type of fish meal consumed: the
Cardiovascular Health Study
published in Circulation.
16 Healthy Heart THE STAR, SATURDAY 29 SEPTEMBER 2018

Breakthrough in stenting
THE imagery of stents often depicts
long metal tubes that are inserted
into the blood vessels close to the
heart to treat cardiovascular
diseases.
However, with breakthroughs in
medical technology, stents can now
be found in detached forms, used
for a procedure called spot
stenting.
Although it is only currently
licensed to be used on the
superficial femoral artery (thigh
area), Dr Shaiful Azmi Yahaya,
consultant cardiologist and deputy
head of the Department of
Cardiology at the National Heart
Institute (IJN), has high hopes on
this procedure being utilised on
other parts of the body in the near
future.
Peripheral artery disease is the
narrowing of the blood vessels
outside the heart throughout the
body, mainly in the lower limbs.
This condition may be a result of
atherosclerosis, which is a build-up
of plaque consisting of fats,
cholesterol, fibrin, calcium and
other substances in and on the
artery walls.
Blood flow is then stopped in a
particular section of the limb or
body, affecting the normal
functions of the body part and the
general health of the patient.
Dr Shaiful shares that when a
blood vessel is blocked by more
than 70%, symptoms of peripheral
artery disease will start to show.
“Pain is an early indicator, but a
blocked artery will also affect
wound healing, where it could take
weeks, months or years to heal a
mere ulcer,” he says.
“Once there is no blood flow, the
tissue will die and eventually The detachable stents are suitable to be placed in the superficial femoral artery where forces are constantly exerted on them by the thigh muscles.
become gangrenous or black.”
If the blocked artery is located in bending of the limbs. It has to be durable enough to cause minimal

the leg, claudication of the leg will
occur, where pain will be felt right
below the part of the blocked
artery.
According to Dr Shaiful, the risk
factors of peripheral vascular
disease are similar to those of heart
diseases – the elderly, diabetics,
smokers and patients with high
cholesterol are at greater risk. To
lower the risks, he recommends
leading a healthy lifestyle.
New grounds
Spot stenting
inert as well so it will not cause complications inside the body.
allergies.
The detachable stents are helpful
as you can choose where to place
Glimpse into causes almost
them in the blood vessels so that the future no side effects
or discomfort to
they can move along with the
limb.” While the use of wires and
Spot stenting takes the form of
six detachable metal stents that are
balloons, balloons only, drug-
eluting balloons and longer stents patients after
very flexible and suitable for areas
where the blood vessels are moved
are still the norm, Dr Shaiful
predicts spot stenting to be the
the procedure,
around through the forces exerted norm in the near future. enabling them
by muscles in the thigh. He explains, “You can choose
to carry out daily
The spot stenting procedure is where to put your stents and the

At the moment, spot stenting

is used to treat peripheral
vascular diseases in the legs. In
the human body, thigh muscles
exert constant force on the artery
or blood vessels through
compression, extension,
twisting and flexion.
Therefore, as the blood vessels
are constantly moving through
body movement, there is need
for a more flexible stent
to accommodate them.
“It has to be very flexible for the
Dr Shaiful (third from left) at a press conference for the first spot stenting procedure in Asia.
carried out through making an
arterial puncture at the groin,
where the doctor will insert the
stents through wires and balloons
to set the stents in
place.
Another benefit is that each
stent is only 13mm long, in
comparison to the longer stents
that could go up to 250mm,
decreasing the complexity of
inserting the stent.
As the stents are made from
nitinol alloy, a compound of nickel
and titanium, it is flexible yet
number of stents used, because at
the end of the day, you don’t want
to leave too many foreign bodies in
the artery. You’ll want to only stent
the required area and leave other
areas alone.”
Spot stenting can be combined
with drug-eluting balloons
as an adjunctive therapy to prevent
further blockage in the blood
vessels.
Another major advantage that
comes with the spot stenting
procedure is that it will make
future surgeries easier to perform
as doctors can simply make an
incision in the part of the blood
vessel that is not stented – between
the detached stents – instead of
having to bypass long stents with
arterial grafts.
Spot stenting causes almost no
side effects or discomfort to
patients after the procedure,
enabling them
to carry out daily activities without
any complications or feeling
that the stents are inside them –
unlike patients who can feel the
longer stents implanted in them.
The nitinol alloy is MRI-safe as
well.
Spot stenting can be slightly
costlier than the usual stent
procedure as it is fairly new and
not widely practised.
Yet, it represents cost saving in
the long run as doctors can expect
less complications when operating
on a patient in the future.
Success and safety
As with all medical procedures,
safety and success rates are the
main priority of the patient. Dr
Shaiful says that spot stenting is
not complicated at all with an
almost 100% success rate.
However, as this procedure is
really new in Asia, there are no
official statistics of its success rate
activities without
any complications
or feeling that the
stents are inside
them – unlike
patients who can
feel the longer
stents implanted
in them. The nitinol
alloy is MRI-safe as
well.
Dr Shaiful Azmi Yahaya
as of now.
The only precaution that he has
for patients who have undergone
this procedure is to continue to
take blood-diluting medication to
prevent blood from sticking to the
stents and causing blood clots.
According to him, patients
should opt for spot stenting as it
leaves a minimal number of
foreign objects in the body and has
no recorded side effects.
“Spot stenting will help us a lot.
Even though it is new, the idea is so
logical, and I feel that the
technology is exciting.”
n For more information, call
03-2617 8200.