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Renowned cardiologist Dr Michael Lim Chun-Leng is Medical Director of Singapore Heart, Stroke & Cancer Centre and Dean of the College of the Asian Pacific Society of Cardiology. In a two part interview with Healthy Times, he gives the lowdown on heart health. Part two will be posted on our blog on Tuesday.

Q. What kind of symptoms indicate an imminent heart attack?

Shortness of breath on exertion, chest tightness or chest pains often precede a heart attack but in reality, many of these patients present with these symptoms only when they are about to have a heart attack. Such symptoms occur when more than 70% of your arteries are clogged up. However, studies have shown that the majority (two thirds) of heart attack patients have only a 40% to 60% diameter narrowing of the heart arteries and do not feel any chest pains until they get a heart attack.

Q. How does advanced technology help with heart disease?

In the last few years, technological advances have made it possible to take X-ray pictures of the heart arteries in three dimensions without the need to put a tube into your body. In the past, the usual non-invasive tests such as treadmill testing, stress echocardiography and nuclear perfusion scans have been used to screen for blockage of the heart arteries. But they can only detect patients with severe blockage, and even then, for those with severe blockage these tests can only pick up 70% to 90% of these patients. Today, CT angiogram of the heart arteries allows us to visualise the arteries within seconds in a safe and non-invasive manner. This test is a painless outpatient X-ray scan. Its greatest advantage is that it will allow doctors to make a more accurate diagnosis and begin earlier treatment of heart disease.

Q. Who is at risk of a heart attack?

The main risk factors are high cholesterol, high blood pressure, diabetes mellitus and smoking. Men, older people, and people with a family history of stroke and heart disease, tend to face a higher risk of cardiovascular disease.

Q. How often should a screening test be taken?

Patients should see their family doctors for annual assessment and to control risk factors. For those who have had a CT angiogram of the heart arteries, it is usually unnecessary to repeat it for at least another five years.

To be continued…

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