August 24, 2008

Early Diagnosis Can Save Lives

By Annie Freeda Cruez

THE journalist was on his way to a nasi lemak breakfast with a colleague when he slumped in the car seat and died. He was just 41. A pulmonary and critical care physician tells ANNIE FREEDA CRUEZ that doctors are seeing more and more young people with coronary heart diseases.

The modern sedentary lifestyle is the biggest culprit in the growing number of heart-related diseases in the country.

Kuala Lumpur Hospital's consultant pulmonary and critical care physician, Datuk Dr Jeyaindran Sinnadurai, says for instance, an officer worker will take a lift to his first floor office rather than use the stairs.

"But it not just taking the lift to the office and leading a highly sedentary lifestyle that will increase the risk factor."

Dr Jeyaindran says a combination of many things, such as a bad diet, fast food, smoking, stressful lifestyles and not exercising regularly contribute to the risk.

In fact, researchers in the United States have calculated that by middle age, the average person's heart is five years older than the rest of his body because of the strains of modern life.

K. Ravi, 45, a company executive who has no family history of heart disease or diabetes, suffered a massive heart attack two years ago.

Doctors know why Ravi suffered the heart attack - he led a stressful working life, never went for regular health screening, smoked heavily and did not exercise.

A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn't restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

Dr Jeyaindran says acting fast at the first sign of a heart attack can save lives and limit damage to the heart. Treatment is most effective when started within one hour of the attack.

The most common heart attack signs and symptoms are:

- Chest discomfort or pain - uncomfortable pressure, squeezing, fullness, or pain in the centre of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.

- Upper body discomfort in one or both arms, the back, neck, jaw, or stomach.

- Shortness of breath may occur with or before chest discomfort.

Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat, heartburn and/or indigestion, .

About one quarter of all heart attacks are silent, without chest pain or new symptoms. Silent heart attacks are especially common among patients with diabetes mellitus.

"Too often patients attribute heart attack symptoms to indigestion, fatigue, or stress, and consequently delay seeking prompt medical attention.

"Early diagnosis and treatment saves lives, and delays in getting medical assistance can be fatal."

Delay in treatment can also lead to permanently reduced function of the heart due to more extensive damage to the heart muscle.

Dr Jeyaindran says cardiopulmonary resuscitation (CPR) may improve the survival rate but it is not easy to do.

He says people who smoke, suffer from diabetes and high blood pressure, are obese and have high cholesterol level are at higher risk of having coronary artery diseases.

Age, sex and family history are also contributing factors.

An interheart2 study, Global Case-Control Study of Risk Factors for Acute Myocardial Infarction, has identified nine risk factors that account for more than 90 per cent of acute heart attacks - smoking, lipids, hypertension, diabetes, obesity, diet, physical activity, alcohol consumption and psychosocial factors.

Each person is solely responsible for his health, says Dr Jeyaindran.

"They must lead a healthy lifestyle by exercising, controlling their sugar, blood pressure, weight and cholesterol and go for regular medical check-ups."

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