By SeeFoon Chan-Koppen
Ipoh Echo spoke to Dr. Lee Boon Chye Consultant Cardiologist at KPJ Ipoh Specialist Hospital on the topic of heart attack and what to do in the event of being confronted with one.
“A heart attack is usually sudden and catastrophic. The most common symptom is pain that radiates from the centre of the chest going to the left and sometimes to the neck and left arm. The pain is more pronounced in men and less distinctive in women. Some people may even mistake it for heartburn,” Dr. Lee elaborated.
“Prompt treatment is essential to reduce mortality rates and improve outcomes and survival of an heart attack will mean a lifetime of medication and lifestyle modification to prevent a recurrence. However what people need to know is that heart attacks are preventable”, he stressed.
On the topic of diet modification Dr. Lee says that coronary disease and diet modification bring contradictory results. The cholesterol consumed in food does not contribute to coronary heart disease. Nor does fat. Whereas refined carbohydrates like sugar does by stimulating insulin production and so does obesity and glucose intolerance. What is needed in dietary modification is more protein and fibre. Taking statins may lower your cholesterol levels but it comes with risks like decreased glucose tolerance, renal complications, muscle aches and it interferes with COQ10, an important enzyme for the heart. If a patient’s risk is not high then taking statins is not justified.
So what are the high risk factors I asked?
“If the patient has proven coronary heart disease: as in having had bypass surgery, having stents in the arteries, suffered a previous heart attack or suffering from angina; then statins are called for.” he added.
On reducing risks of heart attacks, Dr. Lee says that one must check one’s cholesterol levels, stop smoking, reduce obesity, control diabetes if one has the problem and finally to control blood pressure.
Dr. Lee went on to reiterate the importance of prompt treatment in the event of a heart attack saying that one third of heart attack patients die out of hospital even though the attack may not be a massive one but combined with ventricular fibrillation, may trigger heart failure.
“Onsite CPR (cardiopulmonary resuscitation) will assist survival and even though family members may not be trained in CPR , if they will start cardiac massage on the centre part of the chest at the rate of 100-120 beats a minute, chances of survival till the patient gets to hospital will be increased. And the sooner they get to the hospital the better the chances.”
“Get someone to drive you. Wake up your neighbour if necessary. Swallow an aspirin or GTN (gylceryl trinitrate) if you have been given some before and don’t panic”, Dr. Lee continued.
On arrival at the hospital and once heart attack has been established, a patient may be given a thrombolytic injection to clear blood clots or immediately undergo an angioplasty where a balloon is inserted to open up the artery that is clogged and a stent placed to keep the artery open.The latter is the preferred method for treating heart attack patients in KPH ISH where they have a 24-hour team on standby with the procedure carried out by a Cardiologist. Only on very rare occasions can a bypass be performed immediately, a procedure which is done by a Cardiac Surgeon and not a Cardiologist.
Dr. Lee recommends screening for heart disease for men after the age of 40 and for women after 50. These tests include an ECG, (electrocardiogram), an exercise stress test, and a blood test for cholesterol and blood sugar levels. If the results of these tests are clear, then he recommends repeating them every three years.
On the subject of the recovery process after a heart attack, Dr. Lee believes that if only one artery was opened up and the heart is good, the patient can resume normal activities gradually after 6 weeks. Isometric or heavy weight lifting exercises are to be discontinued for life except for light aerobic or cardiovascular activities. For those with complications, activities must be individualised and discussed with your cardiologist. As for resuming sexual activities, Dr. Lee feels that it can be resumed after two weeks provided the patient is able to climb two flights of stairs. Nevertheless this too is something to be discussed with your doctor.
Dr. Lee Boon ChyeSuite 2-22KPJ Ipoh Specialist Hospital, 26 Jalan Raja DiHilir, 30350 Ipoh.Tel: 05-2408777, 05-2533720