What is a Heart Attack?

September 28, 2020
heart attack in malaysia
Our heart is the most important organ in the human body as this organ pumps relentlessly from the day that we are born and doesn’t stop beating even when we are asleep. In fact, our heart pumps about a million barrels of blood in an average lifespan. Therefore, the heart is like the engine of the human body. If anything goes wrong with the heart, all the other organs will also be affected.

The prevalence of heart disease in Malaysia is ever increasing. What used to be a disease of the elderly is now seen much earlier. Nowadays, Malaysians in their 20’s and 30’s are suffering from heart attacks. Heart disease is still the number 1 killer in Malaysia. Almost 1 in every 4 deaths is caused by heart disease. On average, about 140 persons for every 100,000 people will suffer from a heart attack during their lifetime.

The risk factor for heart disease can be divided into non-modifiable and modifiable risk factors. The non-modifiable risk factors are age, sex and family history. The modifiable risk factors are namely diabetes, hypertension, smoking, hyperlipidaemia and obesity.

The typical symptoms of a heart attack are left sided or central chest pain, nausea, sweating, left arm pain and jaw pain. However, some patients like those with diabetes may not have chest pain and only have difficulties in breathing. Women are another group that often doesn’t have the typical symptoms, and they often present with epigastric pain.

What actually happens during a heart attack? Our heart has 3 main blood vessels that supply blood to the heart muscle with a diameter between 2.5 to 4mm. A diseased blood vessel can slowly get narrowed over time due to atherosclerosis. In an acute myocardial infarction, the atherosclerotic plaque ruptures and the blood that normally flows within the lumen of the blood vessel is exposed to the lipid rich contents of the atherosclerotic plaque. This causes the blood to form a clot and thus occludes the flow of blood within the blood vessel. Once this happens, the heart muscle cells will start to die and the heart will become weaker until it finally fails to pump blood.
Time is of the Essence
Heart attacks can occur at any time, but they usually occur in the early hours of the morning. This is due to our Circadian rhythm. During a heart attack, time is of the essence. Every second that passes results in millions of heart muscle cells dying and the heart getting weaker. Therefore, the most important thing to do if one is suspected to have a heart attack is to call 999 to get to the nearest hospital with 24-hour primary angioplasty.

It is important to emphasise here that not all hospitals provide 24-hour primary angioplasty and that only thrombolysis may be done. Primary angioplasty has been proven to be superior to thrombolysis. Columbia Asia Hospital – Iskandar Puteri is one of the hospitals which have been offering 24-hour primary angioplasty since July 2018. Led by Interventional Cardiologist, Dr Dhanan Umadevan, Columbia Asia’s catheterization laboratory is staffed around the clock on standby to provide emergency treatments to patients with acute heart attack. For more information and enquires, please call 07-233 9999.

Consult with our heart specialists today for more advice and any concerns related to cardiovascular health

Photo credit: Freepik.com
Dr. Dhanan Umadevan
Consultant Cardiologist
Columbia Asia Hospital - Iskandar Puteri

MD (USM), MRCP (UK),, Interventional Cardiology IJN (Mal), CBCCT (USA), OHD NIOSH (Mal)

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  This article first appeared in The Iskandarian, 17 September 2020.
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