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Steps to Heart Health 1 – October 1st, 2005

Datuk Dr. V.Kathiresan,
Consultant Cardiac Anaesthesiologist,
Damansara Heart Centre,
Kuala Lumpur

Heart is the most important part of our body. Its indispensable quality could even be highlighted from our daily casual exchange of words like, “hearty congratulations’, ‘hearty welcome’, ‘hearty thanks’ and so on. To highlight its importance further, heart is the sign for love universally. So, there is no doubt heart is most important. It is important for people to know about the values of heart and the ways to maintain the well being of our heart.

1. When people suffer from heart disease, one’s mind boggles at different thoughts. They are
2. Why did it happen to me?
3. How will it affect my daily routine?
4. What are the consequences that I would face during my stay in the hospital?
5. What will the impact be?
6. Will it affect my sexual life?
7. Will it lower my self confidence?

The above doubts are very norm and I intend to clear these doubts through this article. Our heart is a pump made out of muscle. It has four chambers and is located behind the chest bone slightly to the left. It is about the size of our fist and weighs less than a pound.

Out of the four chambers the right sided chambers receives the blood from all parts of the body and pumps it to the lungs. In the lungs carbon dioxide is removed from the blood and oxygen is added in. The oxygenated blood reaches the left sided chambers from where it is pumped to the rest of our body. If the pump has to work properly the heart muscle needs energy mainly oxygen and nutrition. The oxygen and nutrition is supplied to the heart muscle through the blood vessels called coronary arteries which is located on the surface of the heart muscles. There are two major coronary arteries. The right coronary artery supplies the right side of the heart and left coronary artery supplies the left side of the heart. Left artery has two main branches one to the front and the other to the back of the heart.


If there is any blockage or narrowing of the blood vessels which supplies the heart that part of the heart muscle may not get enough blood supply. When we do some exercise, work harder or under stress our heart beats faster than normal. When the heart beats faster it needs more oxygen and nutrition. The narrowed blood vessel will not be able supply enough blood to the fast beating heart. So we may face some chest pain which is called “Angina ”. The anginal pain will be mainly on the left side of the chest and may spread to the left hand, back of the chest, to the neck or jaw. Some may even experience pain over the stomach which may mimic gastric pain. The pain may be associated with excessive sweating and breathlessness. The pain may be relieved by rest. When the blood vessel is totally blocked, that part of the heart muscle which is supplied by that blood vessel does not get any blood supply and may be completely damaged. This is called heart attack or “ Myocardial Infarct ”. If a major blood vessel is blocked the major part of the heart muscle may be damaged and it is called massive heart attack. People may die suddenly due to massive heart attack.


The risk factors can be categorized into two. They are:
Unavoidable risk factor.
Avoidable, preventable or curable risk factor.


Older age group people are more prone for heart attack than the younger age group. Those who are between the ages of 40 to 60 are more prone for the heart attack than the younger age group. Those who are below 40 years old also can get heart attack due to various reasons but it is rare.


Normally men are more prone for heart attack than women. Until the menopause the women are protected from getting the heart attack by the female hormones. After the menopause if they get heart attack it will be more severe than the men.


Heart attack may have the genetic influence. It may run in the family. If both the parents had heart attack the chances of their children getting the heart attack is much higher than the normal parents. In a multiracial community some races are more prone for heart attack than other races. Generally Indians have four time’s higher chances of getting heart attack than Chinese or Malays. In Malaysia 35% of the admissions for heart attack are Indians comparing their population of only 8%. The reasons could be attributed to various factors like our life style, food habits and emotional behavior. Indians eat more deep fried food. They add lot of coca nut, ghee, butter and sugar in their cooking. They eat more mutton than the others. These food can increase the blood cholesterol level higher. Genetically the size of the coronary arteries (the blood vessel that supplies the heart muscle) is much smaller for Indians. So the blood vessel can easily be blocked.



Smoking is an important risk factor which can be avoided. The chances of smokers getting heart attack is twice that of non smokers. If they get an attack the chances of they dieing is much higher than the non smokers. Even the passive smokers who sit beside the smokers can get heart attack. If the smokers stop smoking they can reduce 50% of the chances of getting heart attack. If they Stop smoking for 15 years their risk of getting heart attack is lowered to that of non smokers. The smokers are also more prone for lung diseases including lung cancer. The blood viscosity of smokers will be much thicker. The thick blood can easily clot in a small blood vessel. Since there is no benefit and more damage due to smoking it is very important for the smokers to stop smoking immediately.

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