SUNDAY STAR, 29 SEPTEMBER 2019

HEALTHY HEART

Keeping it in check
As the body’s engine, it is crucial to ensure the heart is
always pumping like clockwork.
2 Healthy Heart SUNDAY STAR, 29 SEPTEMBER 2019

When the rhythm breaks

By SRIMAYEE SEN SARMA

IT can be shocking to witness

athletes collapsing and dying on
the sports field. The sports world
bore witness to such tragic
occurrences several times, and
Malaysia went through this
heartache when its very own
national cager Jacky Ng Kiat Kee
passed away while on an
invitational tournament in China.
The cause of his death was
sudden cardiac arrest (SCA),
which is a leading cause of death
among young athletes globally.
What makes cardiac arrest scary
is the element of surprise. It can
affect anyone at any time and can
happen without any warning
signs. Even young athletes who
are supposedly fit and healthy
can die from SCA, as have been
the case numerous times.
According to Dr Koh Kok
Wei, consultant cardiologist at
Subang Jaya Medical Centre and
Malaysia Heart Rhythm Society
chairperson, an SCA victim’s life
can only be saved if
cardiopulmonary resuscitation
(CPR) is started immediately.
“Having said that, the fact
remains that CPR alone cannot
revive the victim. It can only
ensure that the oxygen supply to
the brain is not hampered. To
save the victim, getting him to an
automated external defibrillator
machine (AED) within five to 10
minutes is crucial because only
an AED machine can restart the
heart,” he elaborates.
In a case that happened in
Penang last year, a 49-year-old
man was revived by five
teenagers with the help of CPR
and AED, 12 minutes after he
suffered cardiac arrest while
playing football.
The question is what causes
SCA and is there a way to prevent
it?

Getting the rhythm right
According to Dr Koh, SCA
happens when the electrical
system of the heart malfunctions,
causing erratic or irregular
heartbeats, or arrhythmia.
However, arrhythmia is not a
disease itself, but a manifestation
of an underlying problem.
Some of the causes of
arrhythmia include coronary
artery disease or heart blockage
and injury to the heart from a
previous heart attack; but the
most common cause is
hypertrophic cardiomyopathy,
which is the thickening of the
heart muscles.
The life after
The survival rate for sudden
cardiac arrest (SCA) is extremely
low in Malaysia. For the very few
people who survive, the fight for
their life does not end there.
Since the heart has stopped
pumping blood, the victim’s
brain does not receive enough
oxygen to work. Different kinds
of medical issues can crop up
depending on the length of time
the brain does not receive
sufficient blood, ranging from
memory loss to partial paralysis
to psychological problems, such
as post-traumatic stress disorder.
SCA survivor Jasmine Wylie
describes the after-effects, “I
have roughly three years missing
from my memory – a few weeks
before the attack to a few years
after. It is like I am a different
person now. There are
fundamental things that are very
different from who I was before
the attack, such as the way I
Age and even apparent good health is no deterrent from sudden cardiac arrest, as it is a leading cause of death among young athletes.
Sometimes, there are prior
symptoms, such as palpitations
but there are usually no warning
signs before the heart suddenly
stops beating. Dr Koh says the best
and only way to prevent SCA is to
diagnose the underlying heart
problem that might cause a
cardiac arrest and treat it.
“There are many diagnostic
procedures to detect arrhythmia,
with the first step being an
electrocardiogram (ECG). The
problem with ECG is that it is
much like taking a picture that
captures the heart rhythm at one
think, how I perceive the world
and how I store and retrieve
information in my brain.”
Wylie is part of a SCA
survivors support group on
Facebook.
Lynn Cassano Russell, a
member of the same group, says
she experiences frequent
seizures. “I also had a mild
anoxic brain injury. I have severe
fatigue and weakness that
doesn’t seem to get better with
time. Although I can function and
do tasks such as take showers
and do my hair, it takes me twice
as long as it did before and tires
me out.
“Sometimes my head feels like
it is spinning and only laying
down helps. Daily life is such a
struggle that I have been put on
permanent disability because of
the lasting effects,” she adds.
Wylie believes that the mental
health side of recovery is mostly
particular instant and the person’s
heart might just be beating
normally then.
“If someone has a family history
of sudden deaths or have risk
factors related to heart diseases,
such as diabetes and hypertension,
they are advised to go for a more
thorough heart screening, which
includes an echocardiogram,
treadmill stress test and Holter
monitor,” elaborates Dr Koh.
Sometimes, even these tests
cannot detect arrhythmia, but
Dr Koh emphasises that it does
not completely negate the
ignored by the medical
community and having support
groups to turn to can help
victims as well as their loved
ones.
“The knowledge and wisdom
of other survivors has made
such a huge impact on how I
have dealt with things and I am
very thankful to live in a time
where I can belong to an online
community, as you don’t meet
very many SCA survivors in
regular life,” she shares.
There is lack of awareness
about SCA in Malaysia and
because of that, there is not a
single support group for local
SCA survivors as well as their
family.
These shortcomings
emphasise the need for Malaysia
to not only focus on widespread
life-saving training but building
a solid support system for people
affected by SCA.
possibility of people with risk
factors, especially those with a
family history of heart disease,
getting SCA.
“In such cases, a diagnostic
procedure is undertaken whereby
healthcare professionals induce
SCA within the hospital. Yes, many
people get scared when they hear
that their heart will be stopped
deliberately, but it is better to see if
there is a problem within a
controlled medical environment
where the doctors are already
prepared to restart the heart, than
have it happen somewhere else,”
he assures.
However, there are instances
when there is no detectable
underlying cause to arrythmia, or
an uneven heartbeat cannot be
diagnosed at all. In such cases, the
only preventive measure is to get
an implantable cardioverter
defibrillator (ICD).
“An ICD can detect a
malfunctioning electrical system
and can send out shocks to restart
the heart or bring the rhythm back
to normal,” says Dr Koh.
However, he says that since ICDs
are expensive, not many
Malaysians can afford it, adding
that high ICD prices is a
contributing factor to the low
survival rate of SCA victims in
Malaysia.
Knowledge saves lives
“There is a dire lack of
awareness regarding SCA,” says Dr
Koh, who also believes the lack of
knowledge leads to many people
not receiving the primary care
needed in emergency situations.
“Many Malaysians confuse SCA
What makes cardiac
arrest scary is the
element of surprise.
It can affect anyone
at any time and can
happen without any
warning signs. Even
young athletes who
are supposedly fit and
healthy can die from
SCA, as have been
the case numerous
times.
with a heart attack when they are
completely different. Heart
attacks can lead to SCA but there
are other things that can cause it,
too. This lack of awareness causes
people to ignore the necessity of
taking safety training such as CPR.
“Every public place should
have AED machines and there
should be clear instructions as to
its location. There should also be
a professional available at all
times to assist in using the
machine because most people do
not know how,” he adds.
Based on Dr Koh’s comments,
taking lifesaving training in CPR
that also teaches you how to use
AED should be made mandatory
in schools, universities and
workplaces, because these
techniques are the only thing that
stands between life and death.
SUNDAY STAR, 29 SEPTEMBER 2019 3
4 Healthy Heart
Omega-3 for
heart health
MARINE Omega-3 fatty acids offer a series of
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Because Omega-3 fatty acids have the
chemical structure of polyunsaturated fatty
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human body, these essential fatty acids must
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Opceden has responded to the rapidly
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Studies show that Omega-3 fatty acids are
essential nutrients that help promote health.
Most fish oil supplements in the
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The human digestive MAL180
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These fats comprise three fatty acids,
such as Omega-3 EPA and DHA, and are
each linked to a molecule of glycerol.
Without glycerol, free fatty acids can
oxidise rapidly. The glycerol helps naturally
stabilise the fat molecules and prevent
breakdown and oxidation.
To digest fatty acids, we need the enzyme
known as pancreatic lipase. Studies have
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fish oil. The hydrolysation process needs to
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KKLIU No.0498/2019
Unusual heart conditions
SUDDEN cardiac arrest, blockages in the
arteries and heart rhythm problems are
topics of conversation, if rarely. However,
there are many heart diseases barely
mentioned because of their rarity. Here are
some rare heart conditions that you might
not have heard of.
Takotsubo cardiomyopathy
Also known as stress cardiomyopathy,
and informally as broken-heart syndrome,
takotsubo cardiomyopathy is a condition
resulting from a sudden weakness of the
heart muscle. This disease can be triggered
by emotional stress, hence the name broken-
heart syndrome.
Initial symptoms of this disease often feel
like a heart attack – complete with chest pain
and breathlessness – but fret not, the
condition is temporary and generally
reversible. Other symptoms include heart
palpitations, nausea and vomiting.
Takotsubo cardiomyopathy was first
discovered in Japan in 1990. The word
takotsubo means “a pot used for trapping
octopus” in Japanese, referring to the left
ventricle of the heart which sort of morphs
into a shape similar to a pot in patients
affected by this condition.
Takotsubo cardiomyopathy is very rare,
affecting between 1.2% and 2.2% of people
in Japan, with 90% of sufferers women. The
average age of patients affected by this
disease is between 58 and 75 years old. Less
than 3% of cases occur in people below the
age of 50.
There is no definitive treatment for this
disease. However, once you are diagnosed
with takotsubo cardiomyopathy, doctors will
most probably prescribe heart medications
such as beta blockers, which will help reduce
the pressure on your heart and prevent
further attacks.
The recovery time for this disease depends
on the patient. Some patients will see
recovery in a few days, while others may
take weeks or months. However, some
patients may continuously experience
symptoms such as tiredness, chest pain and
lack of energy as the shape of their heart has
changed permanently.
Tetralogy of Fallot
The odd name for this disease comes from
French doctor Etienne-Louis Arthur Fallot,
who first described it in 1888. Tetralogy of
SUNDAY STAR, 29 SEPTEMBER 2019
Tetralogy of Fallot cases that
goes untreated may develop
severe complications over
time which might result in
death or disability during
early adulthood.
Fallot is a rare condition caused by a
combination of four heart defects that are
present at birth. These defects cause
oxygen-poor blood to flow out of the heart
and to the rest of the body. Most of the time,
children and infants affected by this disease
will have blue-tinged skin due to the fact
that their blood does not carry enough
oxygen.
The signs and symptoms of this disease
may vary depending on the degree of
obstruction of the blood flow out of the
right ventricle and into the lungs.
Besides cyanosis, which is a bluish
colouration of the skin due to low
oxygenation of blood, clubbing of the
fingers and toes is also one symptom,
alongside shortness of breath and rapid
breathing, especially during exercise and
feeding.
While the definite cause of Tetralogy of
Fallot is still unknown, there are varied
circumstances that can contribute to the
risk of a baby being born with this
condition. This may include the mother
contracting a viral illness, such as rubella,
during pregnancy. Some research has also
shown that pregnant women who consume
a lot of alcohol and have poor nutrition can
cause the baby to have the disease.
Babies who are diagnosed with Tetralogy
of Fallot need to undergo corrective surgery
because without treatment, they might not
be able to grow up properly. Serious
complications may affect babies suffering
from the disease, such as infective
endocarditis, which is an infection of the
inner lining of the heart or heart valve
caused by a bacterial infection.
Tetralogy of Fallot cases that goes
untreated may develop severe
complications over time which might result
in death or disability during early
adulthood.
SUNDAY STAR, 29 SEPTEMBER 2019 Healthy Heart 5

Healthier heart,
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6 Healthy Heart
Fooled by television?
THE portrayal of medical scenes in television
shows have been long debated. The
misconceptions about a certain disease and
how it is supposed to be treated have also
become the talk among doctors and health
practitioners, who feel the need to warn
viewers not to believe everything they
watch.
Here are some of the most common
misconceptions in regard to heart disease in
television.
Everyone who gets CPR survives
Contrary to what you see on television, it’s
rare for a doctor to completely revive a
patient through cardiopulmonary
resuscitation (CPR). Though CPR is still one of
the best things a bystander can do if
someone’s heart stops beating, it’s not an
instant cure.
Dr Snehalata Topgi, one of the doctors
from ParaDocs Worldwide, a medical service
for events, told INSIDER “The point of CPR is
to keep blood flowing to the brain until
blood circulation and breathing can be
restored at the hospital. Many times, this is a
temporary fix and once the CPR stops, the
patient is back at death’s door.”
The truth of CPR’s effectiveness is far
worse than what is shown on television.
Although accurate figures vary, according to
American Heart Association 2014 data, only
45% of out-of-hospital cardiac arrest victims
survived when bystander CPR was
administered.
When a patient has flatlined, just
use a defibrillator.
This is a popular scene in medical shows:
A patient flatlines and doctors rush to
resuscitate her by using jolts of electricity
While watching medical
scenes on television, viewers
are advised not to take it
too seriously. Most medical
shows are created with the
intention of selling the plot,
which is prioritised over
educating viewers.
from defibrillator paddles. It sounds logical.
It’s also totally wrong.
In real life, when a flatline appears on a
heart rate monitor, it means the heart has
stopped beating. A defibrillator’s function is
to deliver a shock to the heart to reset its
rhythm and is used to fix an irregular
heartbeat. However, a patient without any
heartbeat is not going to gain much from a
big electrical shock.
“The defibrillator only works on specific
heart arrhythmias. Asystole, another word
for flatline, is not one of them. This always
makes me laugh when I watch a scene
showing that in television or movies. You
only defibrillate ventricular tachycardia and
ventricular fibrillation,” Dr Topgi said.
Stabbing someone with
adrenaline in the heart will not
cure their OD.
Dr Nikki Stamp, a cardiothoracic surgeon,
in an article for KevinMD, said that while the
scene in Pulp Fiction where Uma Thurman’s
character was stabbed in the chest with
Even though many TV shows have medical advisors on set to ensure some level of
authenticity, it's still best to leave diagnosis and treatment to the experts.
adrenaline by John Travolta’s character
after she overdosed on heroin was the best
scene of the entire movie, the act itself is
not going to work in real life.
She said that she has given an
intracardiac adrenaline while in cardiac
surgery before, but it was done with an
open chest where she could directly see the
heart and even then, things could go wrong.
She also said the act of using adrenaline in
that way is very uncommon, adding in her
article that stabbing into someone’s heart
with a needle can make the heart bleed,
Make the switch
to krill oil today
OUR health becomes ever more important as
we grow older. It is influenced by many
behavioral and dietary factors. However,
some health concerns can be alleviated
through regular doses of eicosapentaenoic
acid (EPA) and docasahexaenoic acid (DHA).
These omega-3 fatty acids can help develop
and maintain cellular health.
One source of omega-3 fatty acids is krill
oil extracted from Euphausia superba, an
Antarctic krill species. Because krill feed on
marine algae that can produce omega-3 fatty
acids, they accumulate these fatty acids in
their eggs and body. The omega-3 fatty acids
can be harvested from krill in the form of
krill oil.
Since the algae the krill feed on can
synthesise the powerful antioxidant
astaxanthin, this carotenoid is also equally
taken up by krill and protects the omega-3
fatty acids from oxidation. The latter is also
the reason for the characteristic deep red
colour of krill oil.
Most importantly, in krill oil the majority
of the omega-3 fatty acids EPA and DHA are
bound to a particular type of fat, called a
phospholipid, whereas in other marine oils,
omega-3 fatty acids are bound to other forms
SUNDAY STAR, 29 SEPTEMBER 2019
which will compress the heart and cause a
condition called cardiac tamponade.
In real life, the actress’ heart would
eventually stop an hour or two later.
While watching medical scenes on
television, viewers are advised not to take
it too seriously. Most medical shows are
created with the intention of selling the
plot, which is prioritised over educating
viewers. Yes, many shows have medical
advisors on set, but when it comes to
health, it is best to leave it to trained
specialists.
of fat, usually either triglycerides or ethyl
esters. This difference impacts the way
these fats are incorporated in our tissues
and used by the body.
Triglycerides are mainly used as either
energy or as energy storage in fat tissues.
When omega-3 fatty acids are delivered
in triglyceride form, some of the omega-3
fatty acids are burned as energy or stored
in the body’s fat reserves and, as a result,
the dosage of triglyceride omega-3 oils
must be large enough to compensate for
that loss to ensure that sufficient omega-3
fatty acids are available at the cellular
level.
Recent studies have shown that
phospholipid omega-3 fatty acids may be
more desirable compared with
triglyceride omega-3 fatty acids as less
phospholipid omega-3 fatty acids are
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Antarctic krill feed on marine
algae that can produce
omega-3 fatty acids and
accumulate these fatty acids
in their eggs and body.
SUNDAY STAR, 29 SEPTEMBER 2019
ACCORDING to the National
Health and Morbidity Survey
2015, non-communicable
diseases such as cardiovascular
disease contribute to an
estimated 73% of mortality in
Malaysia, with the biggest
contributor being
hypercholesterolemia, which is
one of the risk factors for heart
disease and stroke.
The formation of plaque in the
arteries resulting from high
levels of blood cholesterol
restricts oxygenated blood flow
to the brain, which can cause
strokes. However, heart disease
and stroke can be avoided by
adopting a healthy lifestyle
through steps such as:
l Adopting a high fibre and
low-fat diet – Increase your fibre
intake by eating more fruits,
vegetables, whole grains or other
cereal products which are high
in soluble fibre, as well as eating
foods that are low in saturated
fat, trans fat and cholesterol.
l Limiting your salt
(sodium) intake
l Be physically active –
Engage in physical activity for at
least 30 minutes on most days of
the week.
l Avoid alcohol or drink in
moderation
l Avoid smoking
Steering you towards a
healthier life
Products made of oat bran,
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Bran Powder, consists of unique
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well-known benefit of lowering
blood cholesterol and reducing
the risk of cardiovascular
diseases.
Oat beta-glucans also help
lower the rise of blood glucose
level. Many health professionals
have promoted its inclusion in
diets for individuals suffering
Know the difference
Many people mistake sudden cardiac arrest (SCA) for a heart
attack. However, according to Dr Koh Kok Wei, chairperson of
the Malaysia Heart Rhythm Society, they are completely
different, and he charts the differences as:
Heart attack
l Caused by
blocked blood
vessels that supply
oxygen to the heart,
causing parts of the
heart muscles to die
l There are often warning
symptoms preceding a heart
attack, such as breathlessness,
chest pain, fatigue and
dizziness
l Only a part of the heart
that does not receive oxygen
because of the blockage is
affected
l In most cases, a
person experiencing
a heart attack can
be saved if rushed
to the hospital and
treatment is begun
immediately
l Heart
blockages can be
easily diagnosed
and can be treated
with medication
and/or surgery
It is important to know the difference so
as to be aware of the symptoms and the
changes in the body because the key to
saving lives is through prompt action.
Healthy Heart 7
Prevention is better than cure
from or who are at risk of type-2
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l Laboratory-tested low in
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l Clinically-tested bioactive oat
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including Physicochemical
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published by The American
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l Good solubility and viscosity
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Sudden cardiac arrest
l Caused by a
malfunction
of the heart’s
electrical system,
causing the heart to
beat erratically or stop beating
altogether
l There are often no
warning signals.
l The heart stops beating
altogether
l When a person gets SCA,
the only way to save her is to
start cardiopulmonary
resuscitation (CPR)
immediately and
apply automated
external
defibrillators to
restart the heart.
l SCA can be caused by
several different
factors. The best
way to prevent
SCA is diagnosing
the underlying
diseases and taking
preventive measures
8 Healthy Heart
Don’t take your age for granted
ACCORDING to Dr Sivarani
Sathasivam, consultant
cardiologist and physician at
ParkCity Medical Centre, heart
attacks are becoming more
common among younger
Malaysians.
“Previously, heart attacks would
generally only occur among
people above 60 years old.
However, we have seen a drastic
increase in heart attack patients
who are below 40 years of age.”
She relates this issue to the
modifiable and non-modifiable
risk factors of a heart attack:
l Non-modifiable – Age and
genetic factors such as family
history of heart attack at a young
Prevention is better than cure
Young people are no longer free
from the threat of a heart attack.
Dr Sivarani Sathasivam,
consultant cardiologist and
physician at ParkCity Medical
Centre lists some steps to reduce
the risks of a heart attack:
l Early health screening –
Screenings are crucial, especially
for adults with a first-degree
family history of heart attacks.
l Stop smoking – Smoking is
an independent risk factor. A teen
When the heart’s rhythm speeds up
YOUR heart will always pump
quickly when doing strenuous
physical activities. It responds to
the increase in demand of the
exercising body. However, if your
heart is pumping fast without a
reason, you may have
supraventricular tachycardia
(SVT).
Ara Damansara Medical Centre
consultant cardiologist Dr Ahmad
Nizar Jamaluddin says SVT refers
to abnormal rapid heart rates that
originate above the ventricles
(supraventricular) in the atria or
AV node. Common symptoms of
supraventricular tachycardia may
include a fluttering of the chest,
rapid heartbeat (palpitations),
shortness of breath, a pounding
sensation in the neck, chest
discomfort, sweating, pale
appearance, dizziness and, in rare
instances, fainting or near
fainting.
Dr Ahmad Nizar says the
underlying causes of SVT are:
l Abnormal automaticity (5%
of patients) – The heart’s
pacemaker sets the rhythm of the
heartbeat. However, abnormal
areas of electrical activity can
trigger and sustain an abnormal
rhythm.
l Abnormal conduction (95%
of patients) – The upper and
lower chambers of the heart are
separated electrically by a fibrous
ring and the atrioventricular
node (AV node) is the only
pathway for signals to travel from
the atria to the ventricles. Some
people are born with extra
muscle tissue bridging the fibrous
ring. In the right conditions,
electrical current carried to the
lower chamber may find itself
travelling back into the upper
chamber through these bridges,
thus causing a short circuit,
resulting in rapid heartbeats.
Triggers of SVT
For some, their SVT attack is
related to an obvious trigger, such
age (especially first-degree relatives)
l Modifiable – conditions such
as diabetes, high blood pressure
and high cholesterol, in addition to
smoking, physical inactivity and
obesity as a result of lifestyle
choices
Dr Sivarani says youths are
developing more of these
modifiable risk factors and most of
them go unnoticed until it is too
late.
Early knowledge, better
prevention
Dr Sivarani sees a need for early
who does not have any other risks
but is a heavy smoker is just as
likely to get a heart attack as
people who are at high risk of
heart attacks.
l Be active – Exercise should
be part of your daily routine, Dr
Sivarani says. “Just like how you
shower and brush your teeth
before bed no matter how tired
you are, exercise must be an
essential daily routine.”
l Watch your diet – It is
Dr Ahmad Nizar Jamaluddin.
as psychological stress, lack of
sleep or physical activity. For
others, there may be no
identifiable trigger. To reduce the
probability of SVT attacks, Dr
Ahmad Nizar suggests the
avoidance of such triggers.
Certain conditions can also
contribute to the development or
increased severity of SVT, such as
pregnancy, surgery, chest
infections, heart failure, thyroid
disease, heart disease, chronic lung
disease, smoking, drinking too
much alcohol, consuming too
much caffeine, the taking of drugs
such as cocaine and
methamphetamines and ingesting
certain medications, including
asthma medications and cold and
allergy drugs. Over time, untreated
and frequent episodes of SVT may
weaken the heart and lead to heart
failure, particularly if you have
other coexisting medical
conditions.
In extreme cases, an SVT episode
may cause unconsciousness or
cardiac arrest.
Diagnosis
SVT is generally diagnosed in
childhood and young adults, but Dr
Ahmad Nizar has observed that
SVTs can occur in adults in their
60s, as well. He relays a case where
the sufferer had his first attack two
days before he was to retire.
detection and treatment and
advocates for earlier health
screening from as young as 30
years old, especially if the person
has a family history of heart attack
and other existing conditions such
as diabetes, high blood pressure
and high cholesterol.
Health screening is important
because even patients at high risk
may not experience any symptoms
until the heart attack occurs. Dr
Sivarani says, “Normally, younger
patients come in for a different
sickness such as a fever or cold.
However, when we check their
vitals and notice their blood
pressure, blood sugar level and
cholesterol levels are high, we will
possible to choose healthier
options, have smaller regular
meals rather than three large
meals and opt for plain water.
l Sleep – Inadequate sleep
results in an increase in blood
pressure, which erodes the lining
of the blood vessels. Cholesterol
will then inhabit the irregularities
in the lining. If one does not have
enough sleep in the long term, it
may lead to increased risk of a
heart attack.
If you feel or suspect that you
are having an attack, the next step
is to go for an electrocardiogram
(ECG). However, some attacks
occur infrequently or in too short
of a span to be recorded at the
hospital. Hence, patients can be
equipped with portable ECGs:
Event loop recorder – For
sporadic episodes of SVT, keep a
portable ECG device available,
attaching it to your body and
pressing a button when you have
symptoms. This lets your doctor
check your heart rhythm at the
time of your symptoms. This device
is generally provided by the
hospital.
24-hour ambulatory ECG – For
patients with frequent SVT attacks,
the portable ECG device can be
worn for a day or more to record
your heart’s activity as you go
about your routine.
Implantable event loop
recorder – This device is inserted
under the skin near the heart for
No point in delaying a cure
Supraventricular Tachycardia
(SVT) is usually not lethal, as less
than 1% of patients are at risk of
severe symptoms. It is also
uncommon, occurring in about
0.04% of the population.
Nevertheless, it can affect and
restrict people’s lives, such as
carrying out physical activities or
complicating pregnancy.
Therefore, Dr Ahmad Nizar
Jamaluddin, consultant
cardiologist at Ara Damansara
Medical Centre, recommends
patients to undergo treatment as
soon as possible, adding,
“Treatment is important,
especially when the patient has
severe or frequent attacks. When
there are other medical
conditions such as coronary
heart disease in older patients, it
may lead to heart failure.”
There are three main
Previously, heart
attacks would
generally only occur
among people above
60 years old. However,
we have seen a drastic
increase in heart attack
patients who are below
40 years of age.
screen them for heart disease. This
is when we discover blockages in
their arteries.”
Unfounded fear of pills
The risk of dying from a heart
attack depends on the severity of
the attack and not on the age of the
patient. Therefore, it is advisable
to seek medical treatment as soon
as you know you have diabetes,
high blood pressure or high
cholesterol.
Some people may be in denial
because they are asymptomatic,
but Dr Sivarani cautions that the
first symptom you experience
might just be a heart attack. The
up to three years. This is usually
for patients with very rare but
severe symptomatic episodes of
SVT.
If arrhythmia cannot be
identified during those tests,
provocative tests may be required
to trigger your arrhythmia. These
tests may include:
l Stress test. For some people,
supraventricular tachycardia is
triggered or worsened by stress or
exercise. During a stress test, you’ll
be asked to exercise on a treadmill
while your heart activity is
monitored.
l Electrophysiological testing
and mapping. In this test, thin
tubes (catheters) tipped with
electrodes are threaded through
your blood vessels to a variety of
spots within your heart. Once in
place, the electrodes can map the
spread of electrical impulses
through your heart. In addition,
the electrodes will allow the heart
treatments – curative,
suppressive and alteration.
Curative
(Radiofrequency)
In this procedure, one or more
catheters are threaded through
your blood vessels to your heart.
Electrodes at the catheter tips
can use heat, extreme cold or
radiofrequency energy to
damage (ablate) a small spot of
heart tissue and create an
electrical block along the
pathway that’s causing your
arrhythmia.
He states, “Close to 100% of
patients will see success with this
procedure. In 5% of patients,
since the tissue is not fully
disabled, recurrence of the SVT
SUNDAY STAR, 29 SEPTEMBER 2019
Dr Sivarani Sathasivam.
decision to refuse treatment and
instead opt for traditional
medicine, exercise and diet without
a doctor’s guidance is also not
advisable.
The fear of taking medication is
a factor, but Dr Sivarani says that it
is actually worth it to start
medication early, especially when
it means you can enjoy good health
and to prevent complications that
may cause irreversible damage.
She says, “Be brave and face
your fear. While it is true you may
have to take medication for the rest
of your life, your quality of life will
certainly be better.”
n For more information, call
03-5639 1212.
to be stimulated and made to
beat at rates that may trigger or
stop an arrhythmia. This allows
the location of the arrhythmia to
be identified and the underlying
mechanism to be determined
What to expect when
you visit your doctor
To streamline the process, Dr
Ahmad Nizar advises, “You have
to expect the doctor to ask
questions about your medical
history, SVT trigger factors,
frequency of attacks, or if there
are any fainting spells. Therefore,
please be prepared with this
information prior to visiting the
doctor. If you have ECG
recordings, bring them along so
there is no need for another
round of tests.”
n For more information, call
03-5639 1212.
occurs days or even weeks after
the procedure. When that occurs,
the procedure must be redone to
fully fix the issue.”
Suppressive (Medication)
SVTs can also be suppressed
through medication. However, it
will be a lifelong commitment for
the patient.
Alteration (Lifestyle
changes)
In patients who have
infrequent attacks, lifestyle
changes may help further reduce
the episodes of SVT. While not
exactly a treatment, lifestyle
changes focusing on avoiding
triggers can reduce the
frequency of SVT attacks.