Got a burning question about heart disease or heart attack? Get it off your chest as Dr Derek Yong answers your cardio queries:

How can I prevent a heart attack?

Adopting a healthy lifestyle choice will reduce your chance of having heart attack. Here’s the reassuring news: you CAN take preventive measures to lower the major risk factors for heart attacks. These include watching out for: Smoking: This unhealthy habit increases the risk of heart attack tremendously. It also increases the tendency for blood to clot easily, damages the inner lining of the coronary arteries, increases blood pressure, increases heart rate and reduces stamina. Obesity: Besides increasing the risk for heart attack and stroke, obesity also ups the chances of developing other modifiable risk factors for heart attack. It increases blood pressure, increases the risk of developing diabetes, raises blood cholesterol and decreases “good” HDL cholesterol. Physical inactivity: Associated with higher risk of developing cardiovascular disease and subsequently heart attack. It’s highly recommended that we should engage in moderate intensity exercise for 150 minutes a week, 75 minutes of vigorous intensity exercise a week or a combination of these activities. Too busy? Even brisk walking for just 20 minutes per day will significantly reduce your risk of developing heart disease. Also, even adults with limited physical limitations are encouraged to stay active for as much as their condition allows. High blood cholesterol: When high blood cholesterol rises, the risk for heart attack also rises. The “bad” LDL cholesterol builds up in the inner walls of the heart arteries and together with other substances, forms plaques that can narrow or block the arteries, increasing the risk for heart attack. To reduce your level of “bad” cholesterol and protect your heart, stick to a prudent diet, regular exercise and lose weight appropriately. High blood pressure: This can damage the heart arteries, increasing the risk of heart attack and stroke. Your risk increases even more if you also have other risk factors described above. To maintain a healthy blood pressure, eat well (reducing salt), avoid cigarette smoking, maintain a healthy weight and exercise regularly. Diabetes: People with diabetes are up to 4 times more likely to have heart disease. It also leads to other complications such as stroke, high blood pressure, eye and foot problems. To prevent or control diabetes, closely manage your blood sugar levels and other risk factors; these will reduce your risk for heart attacks significantly.

I'm still young and healthy. Do I really need to worry about heart disease now?

You wouldn’t have to worry about heart disease in future if you start taking care of your heart early. If you are 20 years and above, I encourage you to go for a health check to identify any potential risk factors, such as high blood cholesterol and high blood pressure, for heart disease. If any specific risk factors are identified, you can receive guidance on appropriate management. Remember, risk factors for heart disease develop over time. Therefore, it’s important for you to adopt a healthy lifestyle by staying active, adhering to a prudent diet and maintaining a healthy weight. Do speak to your doctor to monitor any development of any risk factors for heart disease.

How will you diagnose if I have heart disease?

I will usually use a few tests in order to make a collective assessment of your condition and determine if you do have coronary artery disease. Electrocardiogram (ECG), treadmill stress test and echocardiogram are amongst the commonly used investigations that I will use to make a definitive diagnosis. If the suspicion for coronary artery disease is high following the results of the initial investigations, a coronary angiogram may be recommended to assess your coronary arteries for narrowings or blockages.

What are the common conditions that are linked to heart disease?

The common conditions linked to heart disease are high blood pressure, high blood cholesterol, obesity, diabetes, fatty liver disease, sleep apnea, stroke and kidney impairment.

Both my parents suffer from heart disease, will I defintely get it too?

It is true that risk factors for heart disease and risk of heart disease are strongly linked to family history. However, having a family history does not necessarily mean that you are certainly going to have heart disease. Even if you do inherit the risk factors from your family such as high blood pressure, high blood cholesterol or diabetes, you must do what you can to change your environment. Take steps to minimize the risks and lower your chances of getting heart disease. You can start off by adopting a good healthy lifestyle as I recommended above, such as eating well, engaging in physical activities and not smoking at all.

What do consider as a "heart-healthy diet"?

Eating healthily can help to reduce risk factors for heart disease such as blood cholesterol, blood pressure and excess body weight. A diet consisting of vegetables, fruits, fibre-rich whole grains, beans, nuts, seeds, legumes, lean meat, poultry and fish is generally considered a heart-healthy diet. Avoid or limit your intake of salt, sugars and “bad” fats (trans fats and saturated fats). “Bad” fats should be avoided in favour of polyunsaturated fats, particularly those found in fish (omega 3). In fact, World Health Organisation encourages consumption of 300-500mg of omega 3 (EPA and DHA) daily. It is also well established that regular consumption of red meat, particular processed meats, increases your risk for heart disease and diabetes.

My friends encouraged me to drink alcohol because they claimed that it is good for my heart. Is that true?

Moderate alcohol consumption may reduce your risk of heart disease but drinking alcohol can also lead to other adverse effects, such as increasing risk of certain cancers and liver problems. To balance the risks and benefits of alcohol consumption, US dietary guidelines state no more than 1 drink (about 150mls of wine) for women, and 2 drinks for men, per day. If you exceed this limit, it may have detrimental effects on your cardiovascular and overall health. As people under the age of 40 years have lower risk of heart disease overall, they are not encouraged to drink alcohol as the risks outweigh the benefits. Bottom line: If you don’t drink in the first place, there’s no need to start drinking.

I want to embark on an exercise program to lead a heart-healthy lifestyle. Should I go for cardiac screening first?

It’s great that you’ve decided to start exercising! Research has found out that people who are physically active appear to live longer, likely as a result of improvement of risk factors for heart disease, leading to overall decrease in incidence of heart-related conditions. In fact, the American Heart Association encourages people to participate in at least moderate-intensity physical activities for at least 30mins every day. However, moderately strenuous physical exertion can very occasionally trigger cardiac events, in particular, heart attacks. This is seen especially in those who are not used to regular physical exercise. The primary purpose to go for a cardiac screening before embarking on an exercise program is to identify if you are at risk for a cardiac event during exercise. In general, for people under the age of 35yrs, the causes for sudden cardiac event appear to be mostly related to congenital heart conditions. On the contrary, most cardiac events that occur in people above 35yrs are due to coronary artery disease. During your cardiac screening, we will conduct a comprehensive history and physical examination as well as an electrocardiogram (ECG). Further tests such as an echocardiogram or exercise treadmill test may be required depending on what we find during the initial examination.

I have some concerns about my heart and I’d like to seek private healthcare treatment. However, I’m concerned about the costs...

It is good that you have recognised your concerns. It is also very important for you to take a step forward to address these concerns by seeking a specialist’s medical opinion. Early detection and prevention of heart disease will save you a lot of unforeseen costs in the future. Should more extensive treatments be required for your condition that is beyond your financial ability, we can work out and explore alternative cost options that are offered in Singapore’s healthcare system. At Restore Heart Centre, affordability and availability to our patients are our top priorities. We are dedicated to making quality healthcare accessible to all.