He was at the peak of his career, with a loving wife and young children. But work was demanding, he smoked to relieve stress and he had little time to exercise. One day, he felt chest pain at work and was rushed to the hospital but unfortunately suffered a cardiac arrest en-route. His life was saved but he suffered severe brain injury resulting in being permanently bed-ridden in a vegetative state.
This is the story of one of the thousands of heart attack patients in Singapore each year, some of whom suffer similar cardiac arrests. Only 5% of out-of-hospital cardiac arrest victims survive, but even for survivors, brain damage occurs as early as 3 minutes after their heart stops.
What is a heart attack?
A “heart attack” happens when an artery (blood vessel) that supplies blood to the heart muscle becomes suddenly blocked causing part of the heart muscle to die. A heart attack carries a high risk of death.
Who is at risk of a heart attack?
People with following conditions are at a high risk of getting a heart attack:
1. High Blood Pressure
2. High cholesterol
3. Diabetes mellitus
4. Family members with heart disease especially at a young age of onset
5. Smoking, Obstructive Sleep Apnoea and Stress
What are the symptoms of a heart attack?
Symptoms can range from heavy, squeezing chest discomfort to breathlessness and a cold sweat. Some elderly patients, diabetics or female patients may have less typical symptoms e.g. breathlessness without chest pain or upper abdominal discomfort.
How do I reduce my risk?
1. A heart healthy diet, exercising regularly, keeping to a good weight and managing stress can go a long way in reducing your risk.
2. Keep conditions like diabetes, high blood pressure and high cholesterol under check and well controlled. Do not be resistant to medications if they are necessary.
3. If you are over 40 years of age, regular screening for high blood pressure, cholesterol and diabetes is advised.
4. Early detection of heart disease can be life-saving if you have risk factors or symptoms.
5. Smoking is a cause of many health conditions and should be stopped. Young people should never take up smoking as it is addictive.
What if I have suspicious symptoms or I think I am at high risk?
Visit your family doctor and if necessary he may refer you to a cardiologist. Your doctor will do a detailed evaluation and may perform some tests, which may include:
1. Electrocardiogram (ECG)
2. Echocardiogram or heart scan
3. Exercise stress ECG
4. CT calcium score or CT coronary angiogram
5. A conventional coronary angiogram
How is this disease treated?
1. Lifestyle changes such as healthy dietary habits, regular exercise and reducing weight. Smoking should be stopped.
2. If you are already diagnosed with heart artery blockage, long term medications are extremely important. The most important of these are blood thinning and cholesterol lowering medications. Other medications may be required to control diabetes and high blood pressure.
3. Severely blocked arteries can very often be successfully opened up by minimally invasive angioplasty (balloon) and stenting
4. A small proportion of patients may require open heart surgery (coronary bypass).
If you suspect that you are having a heart attack, get immediate medical attention. Certain types of heart attack require emergency angioplasty and stenting to unblock a totally occluded artery. “Time is Heart”. Every minute counts!