Dr Lim Choon Pin
Every year, over 17.5 million people worldwide die of cardiovascular disease, which includes common heart problems such as coronary artery disease, stroke, and hypertensive heart disease. In Singapore, cardiovascular disease is the 2nd leading cause of mortality after cancer, accounting for 1 in 3 deaths in 2017. Given the prevalence of cardiovascular disease, it is important that we take good care of our hearts.
It is normal for your heart rate to increase to around 90 – 100 beats per minute with increased stress or as you move around during the day. Your heart rate can go even higher with more strenuous activities. If you do not feel out of breath, there is probably no cause for worry.
Apart from having a heart-healthy diet and controlling your blood pressure and cholesterol levels, a regular exercise regime can help improve your cardiac health. Exercising at least 30 minutes a day for 5 times a week at moderate intensity is usually recommended. If you're just starting on an exercise regime, it is important for you to progressively increase the intensity and frequency. This is to prevent unnecessary joint injuries. It also helps your heart gradually adjust to the increasing demand of physical activities. Different people will be able to push their bodies to different limits. Clear signals to stop whatever physical activities you are engaging in include chest pain, dizziness, fainting or extreme shortness of breath.
Sometimes after a meal, the full stomach may cause splinting of the diaphragm, making it difficult to take a deep breath. This is usually not related to the heart. As for the tiredness, there are many possible causes such as anaemia (lack of red blood cells), hormonal imbalances, or kidney, heart or lung conditions. It would be best to see a family doctor to have this assessed.
Chest pain that spreads to the left arm may be the result of a condition known as angina (chest pain caused by blockages in the heart arteries). This is usually brought on by physical exertion and relieved by rest. As there may be other causes of this symptom, such as a muscle strain, it is advisable to get this assessed by your family physician or cardiologist.
Some people may have occasional extra heartbeats (ectopic beats) that are picked up by the automated blood pressure machine as an irregular heartbeat. Other heart rhythm problems such as atrial fibrillation or atrial flutter can also result in the detection of an irregular heartbeat. It can also be a wrong reading by the machine. It would be advisable to go to your family doctor to get an electrocardiogram (ECG) performed to assess this. In some cases, a longer period of monitoring may be required to detect the irregular heartbeat – these will need to be assessed by a cardiologist.
An ECG is a non-invasive way of assessing the electrical activity of the heart. It is a very simple test and does not involve radiation or medication. It is safe for everyone. There is no lower or upper age limit as to who can do an ECG.
Mitral valve prolapse is caused by incomplete valve closure and results in blood leaking back to the preceding chamber (in this case, the left atrium). This condition is best assessed by an echocardiogram (ultrasound study of the heart). Depending on the severity of leak detected, you may need regular follow-up scans. Symptoms such as breathlessness or leg swelling usually occur when the degree of leakage is severe. Mitral valve prolapse is usually not a medical emergency – you can arrange for a date to visit a cardiologist to have your condition assessed further.
It is unlikely that mitral valve prolapse will result in your symptoms of limb numbness. However, weight gain can cause this numbness, especially in the hands – this condition is known as carpal tunnel syndrome. See your family doctor to have this evaluated.
There are many causes of heart murmurs in a child. Some causes include congenital (inborn) heart defects such as a hole in the heart or abnormalities of the valves. These conditions may need treatment. More commonly it may be flow murmurs, which are a result of angulation of blood vessels and not a concern to the health of the child. It is best to have your child's murmur assessed by a paediatrician.
When someone experiences a heart attack, it is important to call for medical help and an emergency ambulance immediately. Stop the person from any ongoing physical activity and get them to sit down or lie down. If the person has a history of heart problems, they may be carrying a bottle of medication called "Glyceryl Trinitrate" or "GTN" that is meant for such emergencies. It should be administered under the tongue immediately.
If the person loses consciousness, check for their breathing and pulse. Commence cardiopulmonary resuscitation (CPR) immediately if these are absent. Remember to get the patient to the emergency department as soon as possible for the necessary medical treatment to be delivered.
Do you have more burning questions on heart health? Tune in to Dr Lim's interview on Kiss92 "Doctors in the House", where our medical specialists dish out weekly advice on topics ranging from aches and pain you shouldn't ignore to dealing with medical emergencies.