ON a dry mid-autumn day in a north-eastern city of the United Kingdom more than 30 years ago, two fine gentlemen sat before me and one of them posed a life-changing question: “Why do you want to become a doctor?”
I leaned slightly forward, with a gleam in my eyes, and explained with self-assured confidence. I must have made a deep impression because after the 20-minute interview, I was offered a place in a medical school.
The turning point for me was when my dad suffered from the dreaded heart disease at a young age. I remember vividly the times when he clutched his chest in pain. I vowed then that one day I would be the doctor who would treat and care for him.
Why cardiology? The heart as an organ has always fascinated me. Just consider this:
THE heart is the first organ to develop in a foetus and starts beating as early as four weeks old and is fully developed by the time the foetus is only eight weeks old. This mean “machine”, the size of your fist, beats around 100,000 times a day and about 2.5 billion times in an average lifespan continuously without even a moment’s rest. Talk about stamina. The heart will only stop when its time is up.
THE heart pumps about five litres of blood every minute and the equivalent of about one million barrels in a lifetime, enough to fill three massive supertankers. Your body has about 5.6 litres of blood that circulates through the body three times every minute, covering 19,000km in a day. That is the equivalent of covering the whole of China’s nine bullet rail systems in one day.
EVEN at rest, the muscles of your heart work hard, twice as hard as the leg muscles of a person sprinting. Bring on Usain Bolt. The power the heart generates in an hour can lift a 1,400kg load 30cm off the ground. Try lifting a female hippo!
IF you were to join all the blood vessels in your body together end to end, the total length would be about 100,000km. That is the equivalent of going around the world more than twice.
Heart disease kills more than 17 million people every year and is the No. 1 killer in the world, Malaysia included. In the 1960s, deaths in our country were mainly due to communicable diseases, such as typhoid, cholera, tuberculosis and malaria. Malaysia’s health system was then in its infancy and our health facilities were inadequate to meet the demands of the population.
With better standards of living and improved medical care, these diseases are now well under control.
Fast forward 20 years, heart disease death rates have reached top of the charts. It has remained there ever since with no foreseeable sign of changing.
The Statistics Department released “Statistics on Causes of Death, Malaysia 2014” at the end of last year and it revealed heart disease as the principal cause of death in the country at 13.5 per cent. The findings also showed that deaths due to heart disease recorded the highest percentage for males at 15.2 per cent and 10.6 per cent for women, the highest being pneumonia for the latter.
Heart disease as the cause of death ranked first in all the three major ethnic groups — Malay (13.1 per cent), Chinese (12.7 per cent) and Indian (18.1 per cent). The findings also revealed that heart disease was the principal cause
of death for the population aged between 15 and 64, at 13.8 per cent.
Despite rapid advances in the treatment of heart disease, the numbers don’t appear to be heading in the right direction. People are still dying of heart disease at an alarming rate. In fact, the age of onset for heart disease has become lower in recent years. Twenty or more years ago, heart attack in the early thirties was almost unheard of. Nowadays, we see full-blown heart attacks among those in their twenties.
Like in other medical sciences, prevention is better than cure. We have to examine the root cause and seek to prevent it from happening in the first place.
For years, we have known factors that contribute significantly to the development of heart disease. While we have no control over some of the factors, like family history, old age, male gender and ethnic factor, we have control over other factors, such as smoking, hypertension, diabetes, abnormal cholesterol levels, obesity and sedentary lifestyle.
Tackling these modifiable risk factors forms the cornerstone of management of this global epidemic. With the rising cost of treatment putting a heavy economic burden on the government, steps must be taken to prevent the problem from escalating or, at the very least, to detect the problem at an early stage. Money and, more importantly, life can be saved this way.
My dad did not live to see me as a cardiologist. He succumbed to this illness 21 years ago and became part of the dreadful heart disease statistics.
It was too late for my dad. But you can still make a change and care for your heart. Do your part.
The writer is a consultant