Malaysia had fallen to Coronary Heart Disease (CHD) for decades as the number one cause of death. A little known fact; victims of CHD in Southeast Asian countries are a decade younger than victims from western countries and Australia.

The average age for a male to develop CHD in Malaysia is 59 years old, and 69 for females. Although men are more prone to have CHD rather than women. Interestingly, CHD is actually the leading cause of death for Malaysian women, not cancer.

CHD is developed by the narrowing of blood vessels by cholesterol plaque, which in turn prevents blood from flowing properly and getting oxygenated which then leads to a heart attack. A heart attack occurs when blood vessels are suddenly closed and this could damage the heart and result in death.

There are multiple risk factors contributing to the development of CHD. One of them is the non- communicable diseases such as diabetes, hypertension or obesity. These diseases are closely related to individuals’ lifestyle choices and are generally avoidable. Individuals leading an unhealthy lifestyle such as having smoking habits, bad eating habits and lack of recreational activity increases the odds of developing CHD.

The genetic predispositions are however, a factor that is unfortunately unavoidable. This points to the inevitable predisposition of an individual to develop CHD if their parents or their parents’ siblings also had CHD.

A person with CHD symptoms should see their doctors immediately so that they may investigate thoroughly to find out exactly what the causes are and how severe the situation is. Most people fail to act quickly when symptoms are present which increases their risks.

With the advancement of modern medical technology, there has been several ways to investigate, diagnose and treat CHD. Medical technology has advanced greatly over the years and investigation and diagnosis became much quicker and more accurate. Here are some of the technologies used for imaging available in Malaysia:

Stress echocardiogram

Stress echocardiogram is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to the body. Paired with an exercise stress test, it can detect a decrease level of blood flow to the heart.

Cardiac MRI

Magnetic resonance imaging of the heart gives an accurate picture of what the heart is doing while under stress. The patient is given medication to stimulate stress and injected with a dye that will “light up” the heart. The MRI can indicate if the blood vessels are narrowed, any damage to the heart muscles and measure the heart function.

Multi-slice CT

A dye is inserted through the vein, and a CT scan is taken of the heart. The scan collects several ‘slices’ of images at the same time. Images of the blood vessels will be constructed to show if there are blockages.

Intravascular ultrasound (IVUS)

A small catheter (less than 1mm in diameter) is passed through the blood vessel and an ultrasound is emitted from it, producing an image of the blood vessels in the heart. Doctors can see the build-up of cholesterol, plaque and calcium within the vessels.

Optical Coherence Tomography (OCT)

This is similar to IVUS, except that optical coherence tomography uses light instead of sound to capture an almost instant image of the heart and blood vessels. The images are much clearer than IVUS.

Fractional Flow Reserve (FFR)

Fractional flow reserve is a test where a fine wire is inserted into the blood vessel to measure pressure and calculate flow down the blood vessel. This allows doctors to determine whether or not the narrowing in the vessel is severe.

These technologies have eased the decision making process when it comes to which treatment a patient should receive, as they are far more accurate than the traditional angiogram.

He went on to say that while there are several treatments available for heart disease, prevention is still the best countermeasure. The best and easiest way to prevent heart disease is by leading a healthy and active lifestyle. It does not have to be a chore and you don’t have to give up having fun.

You just have to incorporate healthy eating habits and exercise into your lifestyle. Once it’s a part of you, it won’t be a hindrance to living your life to the fullest.

Dato' Rosli

Note: Datuk Dr Rosli Mohd Ali is the head of the department of cardiology National Herat Institute or IJN (Institut Jantung Negara).

Medical Advancements Help Detect Coronary Heart Disease
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