Heart Attack and Minimizing The Risks

What is your risk for a heart attack and how can you prevent one?

Extensive research has identified factors that increase a person’s risk for coronary heart disease in general and heart attack in particular.

The more risk factors you have, and the greater the degree of each risk factor, the higher your chance of developing coronary heart disease – a common term for the buildup of plaque in the heart’s arteries that could lead to heart attack.

Cardiovascular disease was estimated to result in 17.3 million deaths worldwide on an annual basis. Seventy percent of sudden cardiac arrests have been attributed to coronary heart disease. 2016 statistic showed that 16 peoples die from cardiovascular disease (heart diseases and stroke) in Singapore every day. Cardiovascular disease accounted for 29.5% of all deaths. This means that nearly 1 out of 3 deaths in Singapore is due to heart diseases or stroke.

How do we prevent the heart attack? Can we minimize the risk of heart attack before it is too late?

1) Let’s be familiar with the telltale signs of heart attack or coronary heart disease.

The symptoms of heart attack or coronary heart disease include chest pain and it is commonly associated with shortness of breath. Other associated symptoms include dizziness, palpitation (a noticeably rapid, strong, or irregular heartbeat), diaphoresis (unusually heavy sweating), nausea, fatigue, reduced effort tolerance, leg swelling, fainting, intermittent claudication (cramping pain in the legs and especially the calves on walking or exercising that disappears after rest) or even epigastric (upper abdomen) discomfort. A person who has coronary artery disease may also be asymptomatic.

2) Know about your health status by early detection of coronary heart disease and proper evaluation of your heart.

What test do we do to detect coronary heart disease?

CT Coronary Angiography is highly recommended as it is very accurate in providing the anatomical information about your coronary arteries. It detects the abnormal narrowing (stenosis) of the coronary arteries ranges from no narrowing (0%), minimal narrowing (<25%), mild narrowing (25-49%), moderate narrowing (50-69%), severe narrowing (70%-99%) to complete occlusion (100%). It also helps to characterize the types of plaques that a person has in the coronary arteries. i.e., calcified plaque, soft plaque or mixed plaque.

In addition, it also provides the important information about the origin and pathway of the coronary arteries. Some people were born with abnormal origin of the coronary artery and the coronary artery runs in abnormal pathway which is at risk of being compressed in between the ascending aorta and main pulmonary artery. This may result in myocardial ischemia (a condition where the heart muscle is starved of oxygen due to inadequate blood supply) and sudden death.

Magnetic Resonance Myocardial Perfusion Imaging (Stress CMR) is frequently used to assess for the presence of myocardial ischemia and myocardial infarction (heart muscle damage due to heart attack) as a result of coronary heart disease. Cardiovascular magnetic resonance is also the gold standard for the assessment myocardial viability.

Other useful assessments include ECG, treadmill exercise test, radionuclide myocardial perfusion imaging, stress echocardiography and cardiac enzymes. Invasive coronary angiography with the aim of percutaneous coronary intervention can also be carried out if patient has clear clinical evidence of significant coronary heart disease with presence of cardiovascular risk factors.   

Read more of this article written by Senior Consultant Cardiologist, Dr Wong Siong Sung of Healthy Heart Specialist Centre.

Original Article link: https://www.hsig.org/heart-attack-minimising-the-risks

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