Sudden death due to cardiac arrest

[Lala81]

Just say you're a triathlete or marathon runner, and that sometimes u get chest pain on running and that u want to check it out.

100% the Polyclinic doctor will refer you. No need come out funny story lah.

 

I think usually the Cardiologist will do some tests.

 

1. Treadmill ECG (not 100%)

- can pick up abnormal ECG when heart is pumping faster

 

2. 2D-Echocardiography (may not do if no particular indication)

- can see the structure of the heart, whether got valvular problems or thickening of heart wall or wall motion abnormalities

 

Together these 2 tests if normal should substantially reduce the risk of anyone with a heart condition.

 

Nothing is perfect of course, these tests all have their own limitation.

I think even in private, these 2 should be also just around 1k or thereabouts bah including consultation...

 

Of course there can be additional/more fanciful tests but these 2 should give you a decent reassurance of your cardiovascular fitness.

if you are above 40++....just say that you felt some chest pains here and there(sort of goreng here and there) and cant really pin point the feeling and say you are very very active ... and if got family history of cardiac arrests... doctor at polyclinic wont even ask further and give you referral letter immediately to national heart centre....SATA and private clinics do it but I feel SGH one is more comprehensive as they do both going full stress (depending on how much inclination you can take to the max ) and also resting stage.

 

Resting ECG is very very limited usage in this area.

Edited March 1, 2015 by Lala81

[Kamani]

Just say you're a triathlete or marathon runner, and that sometimes u get chest pain on running and that u want to check it out.

100% the Polyclinic doctor will refer you. No need come out funny story lah.

 

I think usually the Cardiologist will do some tests.

 

1. Treadmill ECG (not 100%)

- can pick up abnormal ECG when heart is pumping faster

 

2. 2D-Echocardiography (may not do if no particular indication)

- can see the structure of the heart, whether got valvular problems or thickening of heart wall or wall motion abnormalities

 

Together these 2 tests if normal should substantially reduce the risk of anyone with a heart condition.

 

Nothing is perfect of course, these tests all have their own limitation.

I think even in private, these 2 should be also just around 1k or thereabouts bah including consultation...

 

Of course there can be additional/more fanciful tests but these 2 should give you a decent reassurance of your cardiovascular fitness.

 

Resting ECG is very very limited usage in this area.

tks Lala81 agreed- but not everyone is a marathoner or triathlete- though I am both - anyways the resting ECG - by this one I mean is that they do a reverse of the incline of your max stress on the thread mill and see how your heart rests down the decline to normal flat levels & if there's any abnormality here again-they just try to be comprehensive to the max - trying to leave no stone unturned... I concur too that this are quite basic tests

[Lala81]

tks Lala81 agreed- but not everyone is a marathoner or triathlete- though I am both - anyways the resting ECG - by this one I mean is that they do a reverse of the incline of your max stress on the thread mill and see how your heart rests down the decline to normal flat levels & if there's any abnormality here again-they just try to be comprehensive to the max - trying to leave no stone unturned... I concur too that this are quite basic tests

 

Yes it's called the Bruce protocol. Reach 85% maximum heart rate then stop. Then still monitor for 5 minutes after stopping.

If u are a triathlete or marathoner, should easily reach stage 5-6 before reaching 85% of your maximum heart rate. Maximum 7 stages.

Edited March 1, 2015 by Lala81

[Ender]

just to input for those whom are above 40++ and very active.... do the stress (thread mill stress test) at least once in about 2-3 years... I do that due to my long runs.... National Heart Centre does it.... I think it costs about $200-300 (if you go thru' polyclinic) route.... apart from the usual cholesterol LDL/HDL stuff

 

Hope this info is of help..... or $0.02 worth of input

Thanks... Is this the VO2Max test? It is alway on my mind to do a VO2Max test on of these days, to see if what's my fitness.

[Kamani]

Thanks... Is this the VO2Max test? It is alway on my mind to do a VO2Max test on of these days, to see if what's my fitness.

Could be ... I never really went into the full dynamics - Lala81 is the best person to ask . I know I went up the max incline with no issues but still does not mean you have a clean Bill of Health

[Ender]

Could be ... I never really went into the full dynamics - Lala81 is the best person to ask . I know I went up the max incline with no issues but still does not mean you have a clean Bill of Health

Solid.. I think I once ask Changi sport clinic how much to do one VO2MAX, a few tears back, somthing around $200 or so.. They put a breathing apparatus over your face and gradually incline the treadmill... PLan to do one of these days.

[nicgrace]

An article from the National Heart Centre Singapore entitled "Sudden Cardiac Death: Are You At Risk?"

 

http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Sudden-Cardiac-Death-Heart-Stop-Beating.aspx

 

Did you know?

• Heart attacks are not confined to the old. Even young men can get a heart attack leading to sudden death.
• 80 per cent of all sudden cardiac deaths are related to coronary heart disease which, in most cases, can be prevented.

What causes young men to die suddenly?

The most common cause is sudden cardiac death (SCD), of which 80 per cent is related to coronary artery disease (CAD) (see box below), with or without a heart attack.

Unfortunately, over half of sudden cardiac death victims have no prior symptoms. Some patients have chest pain, breathlessness or sweating. When these occur in a patient at risk of heart problems, treatment should always be sought immediately.

An SCD attack is not the same as a heart attack. SCD is caused by an abnormal heart rhythm due to abnormal ‘electrical circuitry’ of the heart. A heart attack is caused by blockage of the arteries supplying blood to the heart. The subsequent damage to the heart muscle may or may not lead to an SCD attack. It is estimated that 1,000 Singaporeans die from SCD every year, about half of whom are below the age of 60.

Learn to recognise these symptoms

• Central or left-sided chest pain often associated with sweating, nausea or breathlessness. The pain is described as something weighing heavily on the chest and is usually brought about by physical or emotional stress. It usually goes away within minutes when the stressful activity is stopped.
• Shortness of breath. Because the heart muscles are damaged by the shortage of blood supply or from a heart attack, it can’t pump blood efficiently to meet the body’s needs.
• Discomfort on exertion, jaw tightness on exertion or after meals. These symptoms immediately subside on resting.

In anyone at high risk for heart disease (eg diabetics, those with high cholesterol, hypertension, a strong family history of heart disease), any chest symptom, even atypical, should be investigated. Diagnosis is made with an electrocardiogram and blood tests.

Treatment may involve hospitalisation and ways to restore blood flow in the coronary artery (by angioplasty or thrombolysis).

If you are around...
1. Call the ambulance immediately. Early treatment increases survival rate.
2. Perform chest compression CPR. This will also improve the chances of survival.

Coronary Artery Disease (CAD)

CAD is a common type of heart disease where fatty deposits accumulate in the coronary artery and impede the blood flow. Reduced blood flow to the heart can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack.

Many people who have this form of heart disease are not aware they have it. CAD develops slowly and silently over decades. It can go virtually unnoticed until it produces a heart attack.

You can prevent or slow down CAD by taking steps to improve your heart health. Drugs and surgical techniques can open up narrowed coronary arteries, but the best long-term solution is to make the right lifestyle choices.

Are you in the high-risk group?

Age: Age increases a person’s susceptibility to heart disease.

Gender: Men are three to five times more likely to have coronary heart disease than women. However, the risk for women increases after menopause. Five to 10 years after menopause, women have the same risk for coronary heart disease as men.

Ethnicity: Compared with the Chinese, South Asians (Indians, Sri Lankans, Pakistanis, etc) are three times more likely to suffer from coronary heart disease. Malays have double the risk compared to the Chinese.

Obesity: People who have excess body fat – especially located around the waist – are more prone to heart disease and stroke even if they have no other risk factors. Excess weight increases the strain on the heart. It also raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL, ("good" cholesterol levels). It is also associated with the development of diabetes mellitus.

Family history: You can be at higher risk of heart disease if your immediate family members (parents, children, brothers and sisters) have a history of premature heart disease. Certain risk factors tend to run in some families. If there is a history of heart disease in your family, you should try very hard to control your other risk factors.

"In general, adults should know their family history of heart disease or sudden death. They should know their cholesterol level and know if they have diabetes mellitus and abnormal blood sugar levels. If you have any high-risk factors, get your doctor’s advice on how to improve those risk factors, change your lifestyle and dietary habits, and embark on a safe exercise programme."

Dr Teo Wee Siong, Senior Consultant Cardiologist, National Heart Centre

 

[Kb27]

bui bui one, those who smoke and drink a lot.

some of them never die one.

 

but of cuz, be careful, too much strenuous exercise can kill.

[Tianmo]

bui bui one, those who smoke and drink a lot.

some of them never die one.

 

but of cuz, be careful, too much strenuous exercise can kill.

 

 

got ppl never die one meh????.......................

[Kangadrool]

Sleep and rest very important. Don't try to be a hero watch movies and tweet on smartphones until late late, then start trying to "repent" in the day time by exercising hard.

 

Farmers worked very hard one, but you never see one collapsing out of a sudden right? 'cos they wake up early and go bed early.

[Kb27]

Sleep and rest very important. Don't try to be a hero watch movies and tweet on smartphones until late late, then start trying to "repent" in the day time by exercising hard.

 

Farmers worked very hard one, but you never see one collapsing out of a sudden right? 'cos they wake up early and go bed early.

 

Farmer is consistent manual work, day after day.

There's no sudden stress.

 

I believe lifestyle plays an important role.

[Hosaybo]

Think exertion, esp sudden ones are always a no no. Body needs to be conditioned. Dun go and run a marathon just because your kaki asked u to tag along and without any built up conditioning, your body and heart is subject to high sudden stress. Slow and steady....pit some effort in training. Body will adapt along the way. Ask the season marathon runner, even they go thru a off season period and work their schedule towards a peak.

[Kamani]

Think exertion, esp sudden ones are always a no no. Body needs to be conditioned. Dun go and run a marathon just because your kaki asked u to tag along and without any built up conditioning, your body and heart is subject to high sudden stress. Slow and steady....pit some effort in training. Body will adapt along the way. Ask the season marathon runner, even they go thru a off season period and work their schedule towards a peak.

This is especially so for those weekend warriors ... but what to do ??.... lifestyle in Singapore with stress deadlines and unnecessary worry for tangible assets and "living with the Joneses" but then again some people are just more prone due to hereditary... so which "factory" to complain to?? about the product

[Lala81]

Thanks... Is this the VO2Max test? It is alway on my mind to do a VO2Max test on of these days, to see if what's my fitness.

 

No.

VO2 max is just a way to test your body's ability to tolerate exercise. It doesn't usually have any relevance to medical health.

 

The treadmill ECG is a test to look at abnormal electrical rhythms or ECG changes during exercise.

[Aventador]

Share my story

 

sometime back was doing FFI for IPPT in SAF

they pasted the pads to do the ECG. After ECG print out came out, I see the doctor face like one kind.

then he tell me have to refer me to SAF heart unit at NUH

 

the feeling sucked when doctor tell you such things. The appointment was scheduled for 1-2 months later

I was thinking, nabeh , wait so long if in between something happen how

 

next day went to private heart specialist. Hoping that SAF ECG machine was lousy.

He did the ECG on the treadmill stress test

 

after running , he look at the print out, got the one kind face again......

 

he said report is not good, said we better do a CT Scan. This is not a good test to take often as they inject you with radioactive isotope and put you in this Huge round donut scanner

 

I could feel the radiation flowing around my body

 

after the scan, went back to doctor for results....

 

the calcium score for everything scanned was zero. he told me congratulations, you are one of the special ones that the body f**ks up the traditional ECG machine with strange electrical readings

 

so i ask him does it mean i am excused IPPT? he said no, please continue.......... nabeh

 

anyway, the night after the SAF test before i saw the private doctor was very depressing, you wonder what is going to happen and whether you going to die soon. not a good feeling

 

take all these tests seriously, as you never know

[Nolicense]

Share my story

 

sometime back was doing FFI for IPPT in SAF

they pasted the pads to do the ECG. After ECG print out came out, I see the doctor face like one kind.

then he tell me have to refer me to SAF heart unit at NUH

 

the feeling sucked when doctor tell you such things. The appointment was scheduled for 1-2 months later

I was thinking, nabeh , wait so long if in between something happen how

 

next day went to private heart specialist. Hoping that SAF ECG machine was lousy.

He did the ECG on the treadmill stress test

 

after running , he look at the print out, got the one kind face again......

 

he said report is not good, said we better do a CT Scan. This is not a good test to take often as they inject you with radioactive isotope and put you in this Huge round donut scanner

 

I could feel the radiation flowing around my body

 

after the scan, went back to doctor for results....

 

the calcium score for everything scanned was zero. he told me congratulations, you are one of the special ones that the body f**ks up the traditional ECG machine with strange electrical readings

 

so i ask him does it mean i am excused IPPT? he said no, please continue.......... nabeh

 

anyway, the night after the SAF test before i saw the private doctor was very depressing, you wonder what is going to happen and whether you going to die soon. not a good feeling

 

take all these tests seriously, as you never know

mine the CT scan no injection leh..

anyway I excuse ippt.. now ippt standard so low I should get $400... NB...

[Lala81]

calcium scoring alone does not require contrast.

Aventador probably underwent CT coronary angiogram + calcium scoring since his ECG was already abnormal.

[Hosaybo]

Weekend warrior....plenty I think. Even if it is 15 min, just find something. Short run, some stretching every day. That might be better than doing anything drastic over 1 hour in the weekend. As we age, body and muscles get stiffer. Stretching helps a lot. Of course there is cardio. Walk more. It helps. Squats etc to train the muscles.... A lot of people in 50s cannot even squat.