There has been a perceptible rise in cardiovascular disease in South-east Asia. The obvious culprits here are unhealthy eating habits and lifestyle. What is your opinion on this topic? Are we oversimplifying a complex problem? What role does stress play here?
I think what the physicians have said are true. They say “We are what we eat”, and our poor diet has led to a rise in conditions like high blood pressure, high cholesterol and diabetes. These are the biggest risk factors for cardiovascular diseases and are often the consequence of an unhealthy lifestyle and diet. Another risk factor is smoking. A smoker has twice the chances of getting a heart attack when compared with a non-smoker. People are also leading a more sedentary lifestyle, which also increases the risk of them developing heart disease.
Most people think that stress plays a major role here since stress can lead to higher blood pressure, higher heart rate. Most physicians believe that stress does contribute to cardiovascular diseases, although it may be hard to prove this. This is simply because it is difficult to quantify stress and thus determine its impact on our body.
What patients are the most susceptible to heart disease? Does genetics play a major role in determining the health of our heart?
The patients with the risk factors of diabetes, high blood pressure, high cholesterol as well as the ones who smoke, are the most susceptible to heart disease. Genetics unfortunately also plays a role in determining your cardiovascular health. Having a first-degree relative suffering coronary heart disease at a young age predisposes you to also developing it. In Asia, studies have shown that individuals of Indian/South Asian ethnicity are at five times increased risk of heart disease when compared to their Chinese counterparts.
If you had one piece of health-related advice as a cardiologist, what would it be?
Prevention is always better than cure. Heart disease, while not 100% preventable, is certainly treatable. We need to start early by being mindful of our lifestyle choices and exercising regularly from a young age. Engaging in moderate forms of exercise for 30 minutes at least 5 days a week will be enough. We should also go for regular check-ups, to keep track of our blood pressure, cholesterol and sugar levels.
One of your sub-specialty is heart transplant. The process can be grueling on the patients. What would you like to say to patients who are waiting for a heart transplant?Heart transplant is a high- risk surgery and is reserved for very sick patients with advanced heart failure. However, a heart transplant can offer a significantly better quality of life for a heart failure patient. I would encourage all potential heart transplant patients to look to the past thousands of patients who have successfully gone through the surgery for motivation and inspiration.
The rate of heart transplants in the world has reached a plateau in the past 20 years. This is simply due to the limited supply of healthy donor organs. Due to an aging population, greater number of people getting cardiovascular diseases and better survival rates due to medical and technological advancements.
One of the most established treatment methods for end-stage heart failure these days is the Ventricular Assist Devices (VAD), otherwise commonly known as an artificial heart pump. The VAD is implanted into the heart and its key function is to pump blood out of the heart to the rest of the body. With a VAD patients have an 80% chance of surviving beyond 2 years, based on statistics from worldwide data. In Singapore, patients who use VAD have an 80% chance of surviving for more than 4 years.
What has been the most challenging aspect of working as a cardiologist?
I have witnessed many patients who were on the brink of death. It is heart-wrenching when we cannot manage to save a patient despite our best efforts. On the other hand, it is extremely rewarding when a patient survives and recovers fully. I think the most challenging part of working as a cardiologist is going through these critical situations with the patients, keeping my emotions in check and not let them affect my objectivity.