Th e HEALTH Plus | JANUARY, 2019
04
p04 i TRUST IJN
Second chance
in life for heart
patients
People living with heart failure faces eternal hardship in
life, as they will be subjected to all life-risking problems,
even with the use of pacemakers, those whose hearts are
tremendously weak will not live a comfortable life
H
EART failure is a condition where
the heart simply cannot pump blood
as efficient as it should, making it
hard for your body to receive enough
oxygen. A multitude of conditions
can lead to heart failure, including
the narrowing of arteries, high blood
pressure, damaged heart muscle, infl ammation of the
heart, and even ones who are born with faulty heart
valves.
People living with heart failure faces eternal hard-
ship in life, as they will be subjected to all life-risking
problems. Even with the use of pacemakers, those
whose hearts are tremendously weak will not live a
comfortable life.
Yet unlike viruses, which we don’t have a cure for,
heart failures do. Th ere is an option for heart failure
patients to live an almost normal life and do normal
things. And in Malaysia, there are experts providing
the cure.
Heart transplant
Th e idea is a simple one, yet might be otherworldly for
some. People with heart failures has the potential to
lead a normal life by receiving a new heart from a donor.
Dato Dr Azmee Mohd Ghazi, Clinical Director, Heart
Failure and Heart Transplant from Institut Jantung
Negara (IJN) explains.
Electric glitch
of the heart
An irregular electrical pulse of the
heart which may cause a stroke in
the elderly or unhealthy
People with AF would have a heartbeat between
300 to 500 per minute, while the pulse will be at
around 120 to 170 pulse per minute.
M
OST know about block-
ages of the heart which
causes heart attacks.
But only a few of us
knows about the electrical part of
the heart, the power that keeps it
beating all the time. And even lesser
knows that when the electrical
impulse is irregular, it heightens
the risk of stroke.
This problem is atrial fibrilla-
tion (AF), and Dr Surinder Kaur
Khelae, a Consultant Cardiologist
at IJN explains. “Atrial fi brillation
is a condition where the heart beats
irregularly. It mostly exhibits in
people who are 65 years old and
above.”
Th e symptoms of AF can usually
be very prevalent and obvious, while
could also be subtle and invisible.
“Th e common symptoms of AF are fast and irregular
heartbeat, dizziness, shortness of breath and fatigue
when exercising. Some however, do not feel any symp-
toms at all, and will only know that they have it during
a routine medical checkup.”
Th e condition, if not treated early, can largely lead
to stroke. Th is occurs when blood clots are formed by
the irregular heartbeat, and it travels all the way up to
the brain to block the passage where oxygen should go
through.
“You are 5 times more susceptible to stroke when
you have AF,” warns Dr Surinder. “Th e condition also
commonly associated with people who have diabetes,
hypertension, coronary heart disease, and who are
TRANSPLANT EXPERT... Dr Azmee
delineates the causes of heart failures and the
ultimate solution to the ones aff ected by it.
“Heart failure can aff ect the old as well as the young.
It all depends on the condition which led the person
to heart failure. Older people might be aff ected by
having high blood pressure, diabetes, or coronary heart
disease. While those aff ected at a young age, it would
most probably be a condition they were born with.”
According to Dr Azmee, heart transplant is defi nitely
the cure for heart failure, however, it is not the only
thing that can be done for heart failure patients.
Managing the condition
“Th e fi rst thing to do when, say, a patient comes to us
with heart failure symptoms is to do a full screening.
We need to know if he or she does in fact have heart
failure, and to what extremes.” He continues, “To a
certain degree, heart failure can be managed quite well
just by taking medication. Patients whose conditions
are milder can live a normal life just by taking medicine
on time every day.”
Although, the more serious ones, whereby the
heart is very weak and is unable to pump the blood
well, doctors such as Dr Azmee will need to prescribe
pacemakers.
“Even a pacemaker can be the solution for some.
Some may not need to go for transplant when they can
already manage through pacemakers and medication.”
Th e more serious cases of heart failure will unfortu-
nately and inevitably, be subjected to heart transplant.
older than 65 years of age.” The
more uncommon one though, is
among athletes. “Athletes who exert
too much may also fall victim to the
condition,” she tells.
Th e question may arise, how to
know if I have AF? When you may
have experience the stated symp-
toms, doctors will usually subject
you to a round of ECG, or a Holter
(wearable ECG recorder).
The treatment
Early diagnosis and treatment can
help prevent the occurrence of
stroke. And treatment and manage-
ment of AF are usually personalized.
Treatment is usually categorized in
two; the fi rst to reduce the risk of
stroke and second is to put the heart
beat back to normal that is back to
sinus rhythm or control the rate.
Th e fi rst part of treatment is the prevention of
stroke, or more specifi cally, the prevention of blood
clots. “For this, we will usually use blood thinners in the
form of oral anti-coagulants. And for those who can’t
take the drugs, they can opt for a left atrial appendage
occluder, also known as a ‘Watchman’.”
“The second treatment for AF is to control the
rhythm of the heart. Drugs are used to either reduce
the heart rate to a more normal pace, or to return the
rhythm back to the normal sinus rhythm. Controlling
the heart’s rhythm can also be done through catheter
ablation. Ablation is an invasive procedure where either