Protect Your Heart: 4 Ways to Lower Risk of Arrhythmia, Heart Attack (Myocardial Infarction), Heart Failure and Heart Valve Disease

1. Heart valve disease

Heart valve disease or valvular heart disease is a disorder or disease of the heart valves, which are the tissue flaps that regulate the flow of blood into and out of the chambers of the heart. 

“This is like the doors of your heart not being able to open or close properly,” explained Clin Asst Prof Lau. 

To learn more about how heart valves work, read this article. 

2. Abnormal heart rhythm (arrhythmia)

“When the heart’s electrical system is faulty, it can lead to abnormal heart rhythm, also known as arrhythmia,” said Clin Asst Prof Lau. 

These abnormal heart rhythms can be slow or fast heart rates, extra heart beats, or irregular rhythms. 

Symptoms of abnormal heart rhythm include:

• A fast heartbeat, pounding or fluttering chest sensations
• Skipping of heartbeats
• Dizziness or fainting spells
• Shortness of breath 

3. Heart failure

Heart failure (also known as congestive heart failure) happens when the heart becomes weak or stiff, thus losing its ability to pump enough blood. 

“This (heart failure) is similar to when the water pump in your home fails and water is not being able to pump properly throughout your home,” Clin Asst Prof Lau explained. 

Symptoms of heart failure include:

• Shortness of breath at rest or on exertion
• Swollen ankles, legs or abdomen
• Difficulty in breathing when lying flat
• Persistent coughing or wheezing with white or pink blood-tinged mucus
• Waking up breathless at night with dry hacking cough
• Sudden weight gain
• Tiredness, weakness and giddiness
• Palpitation (increased heart rate) or irregular heartbeat 

4. Heart attack (myocardial infarction)

A sudden blockage of a blood vessel or “pipe” of the heart is what causes a heart attack, also known as a myocardial infarction. 

“Another common misconception is that heart attacks are the result of a progressive clogging of arteries, when in fact they are unpredictable events due to sudden plaque rupture,” says Clin Asst Prof Lau.

What happens during a heart attack

a) The build-up of plaque (fatty deposits) in the inner lining of the artery, also known as coronary atherosclerosis, results in the narrowing and hardening of the coronary artery.  

b) During a heart attack, blood flow that carries essential oxygen to a part of the heart muscle is severely reduced or completely blocked, usually caused by a ruptured plaque. 

c) This leads to a subsequent blood clot forming in the coronary artery. This blockage causes the affected heart tissue to start dying, requiring immediate emergency medical treatment to restore blood flow and prevent permanent damage. 

Symptoms of a heart attack include:

• Sudden onset of heavy or crushing chest pain when at rest or with minimal exertion that does not spontaneously go away
• Sudden shortness of breath
• Pain or discomfort in the arms, back, throat or jaw
• Cold sweat, nausea, dizziness or light-headedness typically associated with chest pain, discomfort or shortness of breath
• Fast or irregular heartbeat

Fortunately, a majority of heart conditions are preventable by managing risk factors and with lifestyle adjustments. 

1. Track health numbers to be aware of health changes

“Check your key health numbers regularly and keep track of what they are, don’t guess,” advised Clin Asst Prof Lau. The numbers you need to monitor regularly are:

a) Blood pressure
A healthy reading is below 130/80 mmHg

b) Cholesterol levels
Nowadays, we do not always rely on a simple cutoff value to decide whether the cholesterol level is good enough.

Rather, we calculate a composite cardiovascular risk score (such as CVD risk estimator by the American College of Cardiology) to estimate your 10-year atherosclerotic heart disease risk, using information such as your age, gender, cholesterol level, smoking habit, sugar control, blood pressure, kidney function, and body mass index.

For those with known coronary artery disease, we aim for a much lower target LDL (bad cholesterol) than years past, to a level less than 1.8 mmol/L (or70 mg/dL), and ideally to less than 1.4 mmol/L (or 50 mg/dL).

c) Blood sugar (glucose)

We also check a hemoglobin A1c level, which is another way to decide if you have diabetes. A HbA1c level of > 6.5% is suggestive of diabetes.

2. Exercise regularly to stabilise plaque

Moderate intensity exercise, such as slow jogging, recreational swimming and recreational doubles badminton, are the best type of exercise for heart health.

Of course, as we get older, our body may not tolerate higher intensity type of exercise, especially if you have not been exercising regularly.

Walking is the safest form of exercise to start if you are uncertain of the level of intensity that your body can cope.

Healthy adults should ideally complete at least 150 mins to 300 mins a week of moderate intensity exercise. A general rule of thumb for what constitutes a moderate-intensity exercise is the “talk test”: you should be able to talk comfortably in full sentences, but cannot comfortably sing a song, during moderate-intensity exercises.

Inactive adults should start gradually, with light or moderate intensity at a shorter duration (<10 min), with sessions spread throughout the week. 

To learn what are the best exercises for your heart, read this article.

3. Make smart eating choices for better heart health

“Don’t anyhow eat! Be smart about your eating by adopting a well-balanced diet. This helps to keep the 3 Highs’ (high blood pressure, high cholesterol and high blood sugar) at bay,” Clin Asst Prof Lau advises. 

Tips for healthy eating include:

• Ensure sufficient fiber in your daily meals
  Take at least 2 servings of fruits and 3 servings of vegetables daily (1 serving = 100 grams)Choose oats, beans, bran, whole-grain bread, and wheat germ.
  
  
• Choose low GI (glycaemic index) foods if you have diabetes/are diabetic
  Choose low GI foods (such as brown rice, low-sugar soya bean milk, fruits) rather than high GI (such as yellow noodles, juice) foods. Low GI foods release sugar slowly rather than rapidly, helping to control blood sugar.
  
  
• Choose leaner protein
  Choose fish, skinless poultry, lean white meat, nuts, bean products and low-fat dairy products. Consume red meat in moderation.
  
  
• Choose healthier cooking oils (unsaturated fat)
  When cooking, opt for healthier oil such as olive oil, sunflower oil, avocado oil.  Avoid saturated oils such as palm oil and coconut oil. Replace coconut milk with low fat/ skimmed milk when cooking curry dishes.
  
  
• Limit saturated fats
  Avoid visible fat and animal fats (butter, cream, ghee, lard) and poultry skin.
  
  
• Minimise trans fats
  Limit hard margarine, deep fried food, pastries, cakes and foods made with vegetable shortening, hydrogenated or partially hydrogenated oils.
  
  
• Limit salt and sugar intake
  Reducing salt and sugar has been shown to help lower blood pressure, blood sugar levels and prevent obesity, which in turn lowers risk of heart disease.
  If you desire more flavor in your dish, you can add herbs and spices, which would enhance the flavor of the dish without the excessive sodium load. 

To learn about the Singaporean-Mediterranean diet that improves heart health by 70%, read this article.

4. Stop destroying your body with harmful habits

Stress if left unchecked, is linked to increased risk of heart disease, high blood pressure (hypertension), chest pains and irregular heartbeats. 

In addition, the way a person chooses to manage stress such as by smoking, overeating or being less physically active, can cause further damage to the body. 

So protect your heart and overall health by:

• Not smoking
• Avoiding alcohol
• Not overeating
• Sleeping well
• Cultivating positive stress management habits 

To know how stress affects the heart and ways to reduce it, read this article.

Ref: F26