Doctor from National Heart Centre Singapore shares how he stabilises abnormal heart rhythms and his day as a doctor, and how he cares for patients.
Cardiologist Reginald Liew tells Joan Chew how he stabilises abnormal heart rhythms
Dr Liew, who was trained in Britain, identifying heart cells from a patient’s skin sample. -- ST PHOTO: LIM SIN THAI
I specialise in abnormal heart rhythms because...
They affect many people, from the very young to the very old.
There are a wide range of treatment options, such as anti-arrhythmic medication and insertion of devices such as permanent pacemakers and implantable cardioverter defibrillators. These devices "shock" the heart back to normal if the patient develops a life-threatening heart rhythm.
Catheter ablation procedures destroy abnormal heart cells that are causing the palpitations.
The heart is fascinating because...
It beats about 100,000 times a day and the heart rate varies according to one's age and fitness level.
I will always remember a case I saw as a junior doctor. A young man was referred to my hospital because the GP felt his heart rate was too slow, at 40 beats a minute.
However, I found that he was very well and was a professional boxer. His resting heart rate was usually around 40 beats a minute as he was so fit.
One little known fact about the heart is...
Heart cells are capable of beating on their own, even when separated from the body.
This is why the heart is still independently active when removed from the body, allowing a patient to receive another person's heart during a heart transplant.
It also means that some parts of the heart can become independently overactive and beat too quickly - one of the reasons why some people experience palpitations.
If I were to give an analogy for what I do, I would...
Be a telephone cable man who connects parts together so they can communicate effectively with one another, and disconnects other areas which should not be connected.
I use a permanent pacemaker to electrically reconnect parts of the heart that have been disconnected by disease.
To eliminate abnormal electrical connections in the heart which can lead to palpitations or increase the risk of sudden cardiac death, I perform a catheter ablation procedure.
A typical day for me would...
Start when I wake up at 6.30am to prepare for work and the kids for school. My mornings are involved with hospital ward rounds, the specialist clinic, meetings with research scientists and may end with a lunchtime talk.
I spend some afternoons in the cardiac catheterisation lab doing procedures.
Back at the office, I often read journals, review papers or write a research article till around 6pm. If I do not have any meetings after work, I usually swim or play tennis.
I try to exercise at least three times a week. Dinner is usually at 7pm, after which I read a book to wind down and put the kids to bed at 8.30pm.
I have come across all types of cases...
Including young patients who were wrongly diagnosed as having epilepsy when they had a heart rhythm problem, and patients whose hearts suddenly stopped beating, but fortunately were able to make it to the hospital on time with emergency resuscitation and made full recovery.
Patients at risk of sudden cardiac death, whose hearts may stop suddenly, include the young and old.
The young ones may have genetic conditions that increase their risk and the older patients may have a history of heart disease such as heart attacks or heart failure.
I love patients who...
Are interested in their own health and take the initiative to improve their lives and well-being.
Some of my more motivated patients bring newspapers or journal articles to show me and ask for my opinion on the data or how a new treatment may benefit them. I am pleased when this happens as it shows that the patients are taking an active interest in their condition. Occasionally, I learn a thing or two from talking to them.
Patients who get my goat are...
Those who go against medical advice or refuse treatment, but still want the doctor to cure their illness.
Things that put a smile on my face include...
My children pretending to be doctors. I've seen Abigail trying to listen to Jonathan's heart with her Hello Kitty toy stethoscope.
At work, I receive a great amount of satisfaction when I see my young patients survive a brush with death, fully recover and return to a completely normal life.
It breaks my heart when...
Patients refuse life-saving treatment because they don't quite understand its benefits.
Some eventually change their minds, especially after family members persuade them to have the treatment, but others die from not having the treatment.
I wouldn't trade places for the world because...
What I do is a real privilege - to be able to help sick people, teach future generations of doctors and contribute to medical knowledge through innovative research.
My best tip...
Is to remain healthy with a good diet and plenty of exercise. If you do develop cardiac symptoms, such as chest pain or palpitations, seek specialist attention early as this could be the first sign of a serious heart condition.
Dr Reginald Liew
OCCUPATION: Consultant at the department of cardiology and the deputy director of the research and development unit at National Heart Centre Singapore (NHCS)
As a young medical student in Britain, Dr Liew was impressed by the cardiologists there, who always appeared to be cool, calm and collected.
He recalled: "I was fascinated by how they would make a diagnosis on the electrocardiogram (ECG) - which seemed really complex to me at the time - then treat the patient with medication or an interventional procedure."
He received cardiology training in two centres in Britain which had the highest volume of patients with abnormal heart rhythms - St Bartholomew's Hospital and StGeorge's Hospital.
The assistant professor at the Duke-NUS Graduate Medical School is part of the team at NHCS that successfully created beating heart cells from skin cells, which could replace heart transplants.
His wife is a medical oncologist and they have two children, Abigail, seven, and Jonathan, five.