Heart Disease

Heart disease is one of the leading causes of death around the world. It is an umbrella term referring to any condition affecting the cardiovascular system, which includes the heart, its blood vessels and the blood. Heart disease is very serious and can turn life-threatening if not managed properly.

In Singapore, there is a total of 31.7% reported deaths attributed to heart disease or stroke in 2020 according to the Singapore Heart Foundation. Heart attack patients are mostly those aged 60 years old and above with men at a higher risk than women.

Risk Factors of Heart Disease

There are several risk factors that can contribute to the development of heart disease. Some risk factors are controllable like lifestyle choices such as excessive drinking, chain-smoking or regular tobacco use, unhealthy diet and inadequate physical activities. Other risk factors of heart disease are uncontrollable, including age, race, ethnicity, family history and comorbidities such as diabetes.

Types of Heart Disease

Heart disease can be classified according to the affected structure and function of the heart. Types of heart disease include:

• Coronary artery disease (CAD)
  It is the most common heart problem wherein the arteries are blocked or narrowed. This reduces the flow of blood to the heart muscle, preventing it from getting the oxygen it needs.
• Heart rhythm disorder (arrhythmias)
  It is a condition that affects the heart’s rate or rhythm and occurs when electrical impulses do not function properly, leading to abnormal or irregular heartbeats.
• Congenital heart defects
  This refers to structural problems or defects of the heart that are present since birth. It usually affects the heart walls, valves and blood vessels.
• Heart Failure
  Congestive heart failure is a serious condition in which the heart is unable to pump a sufficient supply of blood to the body, which can lead to organ failure.
• Cardiomyopathy
  It is a disease that causes the heart muscle (myocardium) to become stiff or thick, resulting in an inability to pump blood to the rest of the body.

Diagnosis for Heart Disease

The doctor will first examine the patient’s medical and family history and perform a physical exam. Afterwards, depending on the suspected condition, the doctor will order blood tests and imaging studies to better diagnose the type and severity of the heart disease.

Other tests include:

• Chest X-ray
  This is done to capture images of the heart, lungs, blood vessels, spine and the bones of the chest.
• Electrocardiogram (ECG)
  This test measures the heart’s ability to send electric signals. It may be used to detect arrhythmias, narrowed or blocked arteries and previous heart attacks.
• Holter monitoring
  This is a portable ECG machine that the patient can wear for 24 to 72 hours, allowing doctors to check for arrhythmias that may not have been captured during a regular ECG.
• Echocardiogram
  This test uses soundwaves to capture clear images of the heart. It can show whether there are problems with the heart’s pumping ability and rhythm.
• Stress test
  This test is done to see how the heart responds to stress (physical activity). It is usually done while the patient runs on a treadmill.
• Cardiac catheterization
  This involves inserting a thin catheter through an artery and into the heart, in order to measure blood flow and pressure problems in the heart and its chambers.

Treatments for Heart Disease

Treatment options for heart disease vary depending on the condition and severity. One of the treatments for heart disease is lifestyle change by having a healthy diet with less amount of sodium and fat, proper body exercise regularly, avoiding smoking and reducing alcohol use. The doctor may also prescribe medication such as anticoagulants and beta-blockers. For severe conditions, surgery may be required. This may involve:

• Angioplasty
  This involves inserting a balloon-tipped instrument into a blocked artery, and gently inflating the balloon to widen the artery and regulate blood flow. It may also involve placing a stent to keep the artery open.
• Bypass surgery
  This involves taking a healthy artery from another part of the body and connecting it on both sides of the blocked artery, thus restoring blood flow.
• Heart transplant
  In more severe cases, the diseased heart is replaced with a healthy one from a donor.