At just 32 years old, Tianfu had a tear in his aorta, a dangerous condition known as Type A Aortic Dissection. Aorta is the largest artery in the human body. While he underwent an emergency, high-risk surgery to repair his aorta, he was told that there was a high risk of a stroke and/or loss of his left leg.


"I remember that Tuesday all too well. Tianfu was taking a long time to prepare dinner so I went to check on him. I found him breathless and terribly pale. Immediately, his brother and I rushed him to the hospital,” shared Tianfu’s partner, Jean. At just 32 years old, Tianfu had a tear in his aorta, a dangerous condition known as Type A Aortic Dissection. Aorta is the largest artery in the human body. While he underwent an emergency, high-risk surgery to repair his aorta, he was told that there was a high risk of a stroke and/or loss of his left leg. 


Singapore Health Inspirational Patient & Caregiver Award recipients, Mr Heng Tianfu (left) with his partner, Ms Jean Sam (right).

A whirlwind of events


For almost a decade, Mr Heng Tianfu was an auxiliary police officer. He led an active lifestyle outside of work such as playing soccer with his friends. He and his partner, Ms Jean Sam, enjoyed exploring new restaurants and cafes together, one of  heir favourite pastimes.

Even though they only knew each other for a few months, talks of marriage was already on the cards. Little did they know that their situation would change overnight. Even though his aorta was repaired, Tianfu suffered a  massive stroke after the operation. The aortic dissection had caused insufficient blood supply to his lower left leg, and resulted in increased pressure and swelling of muscle. Tianfu had to also undergo a procedure to relieve these symptoms. After the surgery, he was also having difficulties to breathe on his own despite using the breathing tube, hence the doctors had to perform a tracheostomy (an opening at the neck with a tube inserted) to help him to breathe. It was a chain of blows to Tianfu. 

​What is an aortic dissection?

​An aortic dissection occurs when an injury or tear occurs to the innermost layer of the aorta, causing blood to flow between the layers of aortic wall and forcing the layers apart. 

With an aortic dissection, there is reduced or no blood supply to the vital organs at times, leading to a heart attack, stroke or even death. An open-heart surgery is required to repair the tear in the aorta.

The symptoms of acute aortic dissection include sudden or severe chest or back pain. Other symptoms may also occur as a result of reduced blood flow to various parts of the body, or due to the pressure exerted on vital organs by an enlarging
blood clot, such as:

  • Shortness of breath

  • Fainting or dizziness

  • Excessive sweating, pale and clammy skin

  • Rapid or weak pulse

  • Difficulty speaking, weakness on one side of the body and blurred vision (similar to stroke symptoms)

​

Dr Naik Madhava Janardhan, Senior Consultant, Department of Cardiothoracic Surgery explained, “In an aortic dissection, blood flows through the aorta as well as into a false passage caused by the tear. This results in some parts of the body not getting the blood supply required. In Tianfu’s case, blood supply to his left leg was affected. To repair his aorta, his heart was stopped during the operation, and a heart and lung machine took over the function of his heart. During this process, blood is re-routed to the machine before it goes to the body. Although the operation restored the blood supply to the body, there was already damage to his leg muscles and sensitive brain tissues.”

Tianfu’s condition worsened when he developed a wound infection in his leg. To stop the infection from spreading and endangering his life, he had to undergo an above-knee amputation.

“When I woke up, I was devastated at the sight of the space where my leg used to be,” said Tianfu.


The road to recovery


Tianfu was emotional from the drastic changes in his life. Not only was he suddenly dependent on others to care for him, being on a tracheostomy also meant he could not even speak, let alone have his favourite food and drinks. He became despondent.

Jean proved to the beacon of light that led Tianfu out of his darkest hours. Even with a full-time job, she made arrangements to be by his side and requested for caregiving guidance from the nurses. Her commitment and infectious positivity moved Tianfu, and slowly, he weaned off the tracheostomy and became motivated to get better. Everyone cheered, including the nurses who cared for him.

Tianfu shared, “After my discharge, Jean moved in with me to be my main caregiver. Although I can feed myself independently, I need help in basic activities of daily living. I am thankful I can count on Jean and my mum for support.”


Control of risk factors and lifestyle modification paramount


Prior to his health episode, Tianfu had been complaining of giddiness, headaches, and aching shoulders on and off – signs of high blood pressure. He attributed these symptoms to his job which required long hours of being outdoors, and not getting enough rest. 

“He (Tianfu) was rarely sick so when he caught a flu and had a headache a few days before the incident, he just took a Panadol, and we still went ahead for a movie. A few days before the incident happened, Tianfu felt nauseated and vomited.  However, the symptoms that he experienced on that fateful day – shortness of breath, profuse sweating, backache, and numbness of leg – all of these were new to us,” Jean recounted. She added that when they arrived at the hospital, Tianfu’s blood pressure was very high and required morphine to control his pain.

After surgery, control of risk factors such as blood pressure, blood sugar and cholesterol levels are crucial in aiding recovery. Additionally, Dr Naik recommends lifestyle modifications such as eating a more heart healthy diet, reducing stress and stopping smoking, all of which go a long way in lowering the risk in getting a recurrent episode or cardiovascular disease in general. 

Since his discharge, Tianfu has cut down on oily and fried food, and started having more home-cooked meals. Jean shared that he now sleeps earlier and no longer smoke as well. These healthier habits help to keep his blood pressure in check. Tianfu has also been referred to the rehabilitation team near his home for follow-up therapy with hopes of getting a prosthetic leg in the near future.

He said hopefully, “I want to get stronger, sit up for a longer time and walk. I would love to travel again, marry Jean and have children of our own. She means the world to me.” 

NHCS currently sees about 40 patients with aortic dissection annually. While this is a rare condition, the numbers are on the rise, indicating a need to further monitor one’s risk factors such as blood pressure, blood sugar and cholesterol levels.

When a serious heart episode such as aortic dissection happens in a younger person, Dr Naik cautioned that it may also be due to rare health conditions such as Marfan Syndrome, Ehrlers Danlos Syndrome and certain Rheumatoid conditions such as Ankylosing Spondylitis. 


Mr Heng Tianfu and his partner, Ms Jean Sam, are winners of the Singapore Health Inspirational Patient and Caregiver Awards 2023 – Patient, and Caregiver Category respectively.


This article is from Murmurs Issue 45. Click here to read other articles or issues.