What are the common heart disease symptoms?

Common heart attack symptoms include:

• Feeling of pain, pressure, heaviness or tightness in the chest
• Pain in the jaw, throat, neck, back or shoulders
• Feeling of coldness in the arms and legs (caused by constricted blood vessels)
• Heart palpitations
• Shortness of breath
• Nausea
• Exhaustion or dizziness
• Weakness
• Fainting (syncope)
• Abnormal heart rate (tachycardia or bradycardia)
• Bluish-purple discolouration of the skin (cyanosis)
• Swelling of the ankles, feet, legs or hands

Make an appointment with your doctor if you experience any of the symptoms above, irrespective of their severity. Your doctor will keep track of your symptoms and provide advice on the best course of action.

Please see the graphic above for details on the specific symptoms associated with each cardiovascular or heart disease.

What are some complications that may develop from heart disease?

It is recommended for you or a loved one to see a doctor if any heart disease symptoms are experienced. If not treated, heart disease may cause:

• Heart failure
• Stroke
• Recurring heart attack
• Peripheral artery disease
• Sudden cardiac arrest
• Aneurysm

What risk factors are associated with heart diseases?

Risk factors of heart diseases include:

• Male
• Older age
• Family history of heart disease
• Obesity
• Smoking
• Diabetes / Hypertension
• High cholesterol
• Lack of physical activity
• Poor diet
• Stress
• Overconsumption of alcohol or caffeine

Heart disease can usually be avoided by adopting a healthy lifestyle. However, certain conditions like congenital heart defects, are present from birth.

How does heart disease affect women?

Heart disease is the main cause of death for women above the age of 40. When a woman reaches menopause (permanent cessation of menses), which occurs at age 50 and above, her risk of heart disease rises considerably. Younger women who have experienced early or surgical menopause are also at increased risk, particularly when these variables are paired with other unhealthy lifestyle practices and risk factors, which include:

• Smoking
• Diabetes
• Obesity
• High blood pressure
• High blood cholesterol (specifically high LDL, or "bad" cholesterol)
• Physical inactivity
• Family history of heart disease
• Pregnancy-related issues, such as preeclampsia, hypertension, gestational diabetes, or increased sugar levels
• Inflammatory and rheumatic illnesses

How is a heart disease diagnosis made? What medical exams are typically used to identify heart conditions?

Your medical history both personal and familial will be discussed with you by your doctor as they examine you. Your doctor will decide which tests are necessary to diagnose your heart condition based on their professional judgement.

To ascertain the heart condition and the most effective treatment options, your doctor may carry out a number of medical tests. The tests may include:

• Blood tests: Blood tests are used to measure the levels of several components in the blood, including triglycerides, vitamins, and minerals as well as cholesterol.
• Electrocardiogram (ECG): An ECG is used to provide a measurement of the electrical impulses in the heart. It helps to indicate how well the heart is beating.
• Cardiac stress test: A stress test, which might also be referred to as an “exercise” or “treadmill”, involves the use of ECG while performing an exercise. It helps doctors determine the functionality of the heart during physical activity.
• Echocardiogram (echo): An echocardiogram produces an image of the heart using ultrasound, a type of X-ray. It enables doctors to check the condition of the chambers and valves of the heart as well as the efficiency of the heart in pumping blood.
• Coronary angiogram: A doctor may perform a coronary angiogram if a patient has had a heart attack or angina. It assists doctors in identifying the amount as well as the location of obstructed coronary arteries.
• Magnetic resonance imaging (MRI): An MRI produces detailed, computerised images of the heart through the use of powerful magnets and radio waves. This test shows the anatomy and functionality of the heart, enabling doctors to choose the best course of action.

For more information on Cardiovascular Assessments and Diagnostic Tools click here.

What do I have to do if I have been diagnosed with cardiovascular disease?

You will begin visiting your cardiologist more frequently once you have been diagnosed. Additionally, you would also be required to make some long-term lifestyle adjustments. You can reduce your risk of developing more severe heart issues in the future by changing your diet and exercising frequently.

When do I need to visit a cardiologist? What signs and symptoms I should watch out for?

The first step to take if you are worried about your cardiovascular health is to talk to your general practitioner, who will refer you to a cardiologist if required. You may be referred to a cardiologist if you experience symptoms such as:

• Chest pain
• Shortness of breath
• Lightheadedness or fainting
• An abnormally slow or fast heart rate
• High blood pressure
• Swelling of the legs
• Leg ulcers or aches due to blood vessel conditions

How can I choose the best cardiologist for me?

One of the most important aspects of the relationship between a healthcare professional and a patient is communication. You should be comfortable with your doctor. You should also check for the qualifications and credentials of the doctor.

Ideally, a general practitioner who is aware of your medical history, as well as any concerns you may have, should refer you to a cardiologist.

The following are some potential reasons you might wish to consult a different doctor or get a second opinion:

• Your communication preferences are different from your doctor's.
• You find it hard to connect with your doctor.
• You are unsure of the expense or safety of the doctor's recommended treatment.

However, you should keep in mind that even knowledgeable medical professionals might not always offer the same recommendations. Hence, it may be beneficial to gather different opinions.

What happens once someone experiences a sudden cardiac arrest (SCA)?

You will probably have to be admitted to a hospital for additional care and treatment, under the watchful eyes of the medical staff after surviving a sudden cardiac arrest (SCA). Medications may be used to help in preventing another SCA from occurring.

The medical staff will work to identify the root of your SCA. You may require angioplasty or coronary artery bypass surgery following a diagnosis of coronary artery disease.

An implantable cardioverter-defibrillator (ICD) is usually planted under the skin of the chest or abdomen of patients who suffered an SCA. ICDs use electric pulses to help regulate irregular heartbeats (arrhythmias) that may be harmful.

What happens following an open-heart surgery?

Depending on the surgery, you may be required to stay in the intensive care unit (ICU) for a day or longer. Once you are ready, you will be moved into a regular hospital room.

You can expect to spend a number of days in the hospital. You will be shown how to take care of your incision by your heart care team.

How long will my recovery from open-heart surgery take?

Your recovery time will vary depending on the procedure, possible problems, and your general health before the surgery. Recovery from an open-heart surgery may take 6 to 12 weeks (or even longer in some circumstances).

What does cardiac rehabilitation involve?

Cardiac rehabilitation is a medically supervised programme and is intended to help patients recover from heart attacks, heart failures, or heart operations. There are three crucial components of cardiac rehabilitation:

• Exercise training and counselling: The cardiovascular and cardiac systems are strengthened by exercise. Patients will be taught how to move in ways that are beneficial for their hearts.
• Education to encourage healthy living to promote heart health: This involves the practice of a healthy diet, quitting smoking, and taking medicine as directed.
• Counselling: Stress can be harmful to the heart. Through counselling, patients can identify and address the sources of stress.

When should someone be screened for cardiovascular risk factors?

Screening for cardiovascular risk factors is advised for adults aged 18 and above. Regular screenings (as advised by a doctor) are recommended for people with conditions such as diabetes, high blood pressure and chronic kidney disease as they are more at risk of cardiovascular disease.

How can I lower my risk of acquiring heart disease?

You can take a number of steps to reduce your chances of developing heart disease and effectively manage the symptoms and advancement of several cardiovascular diseases. These include making significant adjustments to your lifestyle, such as:

• Keeping a healthy weight
• Practising a healthy and balanced diet
• Exercising or partaking in physical activities on a regular basis
• Stopping or avoiding smoking
• Getting a good amount of sleep
• Controlling your consumption of alcohol
• Managing other health conditions (e.g., high cholesterol, hypertension and diabetes)
• Reducing and controlling your stress levels

What dietary changes should I make in order to reduce my risk of developing heart disease?

Practising a healthy diet helps lower the likelihood of developing heart disease.

Here are some dietary changes you may adopt to reduce your chance of developing heart disease:

• Reduce your intake of processed meat and refined carbohydrates
• Increase your intake of fruits and vegetables
• Increase your intake of foods that are rich in fibre and low in saturated fats, trans fats and cholesterol
• Limit your intake of salt and sugar

How is the risk of developing a heart disease affected by a lack of exercise?

Heart disease has been shown to be directly associated with a lack of regular exercise or physical activity. Exercise reduces the risk of heart disease through:

• Maintaining a healthy weight
• Reducing the blood pressure
• Increasing blood flow and preventing the formation of clots
• Promoting good cholesterol
• Possibly lowering the bad cholesterol and triglyceride levels, which are 2 key factors that contribute to heart disease
• Reducing or preventing the progression of diabetes
• Reducing or preventing the progression of diabetes

The American Heart Association recommends that adults engage in at least two and a half hours of moderate exercise each week. You can also lower your stress levels and improve your mood by looking after your heart. It is time to start exercising to promote your heart health!

How does smoking trigger heart disease?

The coronary arteries deliver oxygen and nutrients to the heart. The risk of developing a heart attack increases when fatty deposits (plaque) accumulate inside these arteries, which may obstruct blood flow to the heart.

The narrowing and obstruction of the coronary arteries are accelerated by smoking. This is as the substances in cigarette smoke, such as nicotine and carbon monoxide, cause the cells that line the blood vessels to enlarge and inflame. The cardiac muscles would begin to die if they are deprived of oxygen and nutrients.

How can I effectively care for a person who has heart failure?

The role of a caregiver of a heart failure patient comprises a variety of tasks and responsibilities, which vary based on the symptoms and comorbidities of the patient, the relationship between the caregiver and patient and the complexity of the treatment plan.

While a huge part of the caregiver's job is to help the patient perform daily tasks and adhere to their treatment plan, it is also vital for the caregiver to offer psychosocial support.

Myth 1: “Heart disease runs in my family, so there isn't much I can do to prevent it.”

Fact: You can considerably reduce your heart disease risk, even if you have a family history by taking certain measures. Maintaining an active, healthy lifestyle can help keep your heart healthy.

Myth 2: “I won't develop any heart diseases as I'm still young. I should only get my health screened when I'm older.”

Fact: People of all ages can develop heart disease and it is becoming more prevalent among young adults. This is in part because the factors that contribute to heart diseases may arise while people are younger.

The risk of developing cardiovascular disease when you are older is significantly influenced by your current lifestyle. The formation of plaques in the arteries can start as early as childhood and could ultimately result in blocked arteries.

Therefore, it is wise to undergo routine health screenings to take control of your cardiovascular health.

Myth 3: “My heart will not be affected by diabetes as long as I take my medication.”

Fact: While, the treatment of diabetes can delay or prevent the development of cardiovascular disease, you still face the risk of developing heart disease and stroke even if you have well-controlled blood sugar levels.

The risk of getting cardiovascular disease is increased by the same risk factors that lead to diabetes. These include smoking, obesity, hypertension and physical inactivity.

Myth 4: “A heart failure means the heart has stopped beating.”

Fact: A cardiac arrest may cause the heart to stop beating. This is not, however, considered to be heart failure. Heart failure refers to a condition where the heart is unable to pump blood to other body parts efficiently. This commonly happens when the heart becomes too weak or stiff. Heart failure, therefore, does not indicate that the heart has stopped beating.

Myth 5: “All cholesterol is bad cholesterol.”

Fact: Specific types of cholesterol are necessary for the health of the body. The body needs cholesterol for vital processes like cell generation and hormone production. Lipoproteins transport cholesterol through the blood.

There are two forms of lipoproteins that carry cholesterol:

• Low-density lipoprotein (LDL): LDL, or "bad" cholesterol, makes up the bulk of the cholesterol in your body. Heart disease and stroke risk are increased by high levels of LDL cholesterol.
• High-density lipoprotein (HDL): The "good" cholesterol, HDL carries cholesterol back to the liver to be removed from the body. High HDL cholesterol levels can lower the risk for stroke and heart disease.

If there is an excess of LDL cholesterol in the body, it can build up in the walls of the blood vessels. This buildup, which is also termed a plaque, may cause the narrowing of the blood vessels. If the blood supply to the heart is impeded, blood circulation between the heart and other organs might then be reduced, which could result in a heart attack or angina.

Myth 6: “I don't exhibit any symptoms of high blood pressure or high cholesterol warning signals, so I must be healthy.”

Fact: High blood pressure or hypertension has often been given the nickname "silent killer" because it may not present any symptoms, leading you to believe you don't have it. Therefore, it is always advisable to get routine medical check-ups as a precaution.

If there is a history of heart disease in your family, you should start getting regular cholesterol levels screened earlier. Children from families with a history of high cholesterol may have elevated cholesterol levels, which increases their heart disease risk as adults.

According to the Ministry of Health's 2019 National Health and Morbidity Survey, 8 million or 40% of Malaysian adults have high cholesterol, which is a significant risk factor for heart diseases.

Myth 7: “I can tell when I am experiencing a heart attack as my chest will hurt.”

Fact: While it is typical to have chest pain or discomfort, a heart attack can also result in more subtle symptoms such as nausea, shortness of breath, dizziness and discomfort or pain in the jaw, neck, back, or arms.

8. Myth 8: “After recovering from a heart attack I should refrain from being active and exercising after recovering from a heart attack.”

Fact: According to studies, heart attack patients who routinely participate in physical activities and make other lifestyle changes to support heart health live longer than patients who do not. Moderately intense exercises are generally safe and good for the long-term health of individuals with chronic diseases.

Myth 9: “The numbness and pain I feel in my leg is not connected to my heart.”

Fact: Muscle pain in the legs may indicate peripheral vascular disease (PVD), which is caused by an accumulation of plaque in arteries (atherosclerosis). People who suffer from this condition are more likely to experience a heart attack or stroke.

Myth 10: “My heartbeat is faster than usual. I must be having a heart attack.”

Fact: It is normal for your heart rate to fluctuate slightly. Your heart rate increases during physical activity or when you are excited, whereas it decreases during sleep. A shift in your heartbeat is typically nothing to be concerned about. However, it could indicate an abnormal heartbeat (arrhythmia). Although most arrhythmias are harmless, some can persist for a substantial amount of time and may affect the functionality of the heart. Such arrhythmias would necessitate treatment.

What is atherosclerosis?

Atherosclerosis is a disease that develops from the accumulation of a sticky substance called plaque in the arteries. The development of atherosclerosis occurs gradually as a plaque forms through the accumulation of substances like blood cells as well as fat and cholesterol deposits.

As a plaque builds up over time, the blood vessels would start to narrow. As a result, less oxygenated blood reaches the vital organs.

Is the brain and heart health connected?

Brain and heart health are closely related. This is as the heart drives blood to every organ in the body, including the brain.

As blood is transported to the brain through blood vessels, any damage to them could result in serious health issues. These health issues are referred to as cerebrovascular diseases, which are diseases that affect the blood vessels that deliver blood to the brain.

Cerebrovascular diseases arise due to a reduction in blood flow to the brain as a result of artery constriction (atherosclerosis), blood clot formation (thrombosis), blockage (embolism), or blood vessel rupture (haemorrhage). The most prevalent cerebrovascular disease is stroke.

Is a stroke identical to an aneurysm?

A stroke happens when a clot or a plaque obstructs ta blood vessel in the brain or if the blood vessel bursts. This results in the death of brain tissue, which impairs memory.

A transient ischaemic attack (TIA), commonly referred to as a "ministroke," happens when the supply of blood to the brain is temporarily cut off or interrupted because of a blood vessel blockage, depriving the brain of oxygen. A type of dementia known as vascular dementia may arise after a series of small, "silent" strokes or "ministrokes", which includes symptoms such as delayed thinking, memory loss, and personality changes.

An aneurysm is a medical term used to describe the weakening of an arterial wall that causes the artery to enlarge and potentially cause it to rupture.

Preserving the health of the blood vessels aids in keeping the heart and brain healthy.

For more information on the warning signs of a stroke click here.

What are aortic diseases?

The biggest artery in the human body, the aorta, is the primary artery that carries oxygen-rich blood from the heart to the rest of the body.

Aortic diseases include:

• Aortic aneurysms, which occur when the aorta swells or bulges as a result of damage or weakening of the aortic wall. The aorta may tear as a result, or it may even burst or rupture (aortic rupture).
• Aortic dissections, , which refer to tears in the aorta which result from aortic aneurysms. An aortic dissection is considered a medical emergency.

What do pulmonary embolism (PE), deep vein thrombosis (DVT), and venous thromboembolism (VTE) mean? What connection do they have to cardiovascular disease?

Venous thromboembolism (VTE) is a term used to describe a blood clot that begins in the vein. VTE comprises two conditions:

• Deep vein thrombosis (DVT) is a condition in which a blood clot develops in a deep vein, typically one that runs through the leg, thigh, pelvis, or arm, though it can also occur in other veins.
• A pulmonary embolism (PE) ensues when a DVT clot escapes from the vein wall enters the bloodstream and travels to the heart and lungs.

Specific surgical procedures (e.g., coronary artery bypass surgery) and conditions (e.g., heart attack and heart failure) increase the risk of developing VTE.