Ask the Experts: Heart Attack Symptoms

Sudden pain or tightness in the chest is one common symptom associated with a heart attack, but did you know that patients may also suffer atypical symptoms that are subtle yet deadly?
Catch up on our Health Talk: Recognising an Unusual Heart Attack below to find out more about the symptoms, risk factors and treatment methods for a heart attack:

Here are more questions from the talk, answered by our speaker, Interventional Cardiologist Dr Lim Ing Haan, and the Singapore Heart Foundation team.

Symptoms of Heart Attack

What are the symptoms of a heart attack?

Is feeling short of breath frequently a concern, and will it lead to a heart attack?
Shortness of breath may be a sign of either heart or lung problems and warrants a visit to the doctor.

Does mild sleep apnea cause a heart attack?
Sleep apnea can affect the heart by resulting in heart attacks or irregular heart rhythm.

Do episodes of heart palpitations indicate heart problems?
Yes, it is one of the symptoms.

Do people with Atrial Fibrillation (AF) display different heart attack symptoms?
Heart attack symptoms are not affected by AF.

Diagnosis of Heart Attack

For a smoker on medication for high blood pressure and high cholesterol, with normal ECG and stress test results, but experiences on and off chest discomfort, what test should he follow up with?
I recommend a more accurate assessment with CTA (CT Angiography) coronaries.

For a person with 40% blockage, when do you recommend doing another CT scan to monitor the blockage?
There are a few options to monitor a person with 40% blockage, and this depends on the managing cardiologist’s recommendations. Usually, a stress echocardiogram or a nuclear is done, and after many years, a repeat CTA coronary scan can be considered.

Is it necessary to have Holter and Echo check prior to a doctor’s consultation? Will the ECG report suffice?
No tests are required before a doctor’s consult as the doctor can perform any tests needed.

If the ECG result is normal, must we still be concerned?
ECG does not predict future events.

How often should we go for health screening, and when should we start?
Every adult aged 18 years and above should go for screening of cardiovascular risk factors (diabetes, hypertension, hyperlipidemia, family history of CVD, smoking). If tests are normal, it is reasonable to repeat testing at a minimum of 3-year intervals.
From age 35, it is recommended to do yearly health screening.

If there are significant cardiovascular risk factors, regular cardiovascular screening or further evaluation for heart disease is recommended.

Can heart attack be detected through angiography? What other tests can be done if a person is old or has a knee problem and cannot go onto a treadmill?
Angiography is the gold standard for diagnosing blockages. A CT scan can be considered if unable to go on a treadmill.

Other Heart Conditions

Is atherosclerosis reversible without surgery?
No

Do Rhinitis and Fatty Liver lead to heart attack?
No

Diet and the Heart

My father drinks 3 cups of kopi with a lot of evaporated milk daily. Will the palm oil in the evaporated milk accumulate plaque and calcify in the arteries?
Most creamers contain palm oil, which is a source of saturated fat (bad fat). Excessive consumption of saturated fat is associated with a higher risk of cardiovascular disease.

Consider swapping creamer with skimmed/low-fat milk for a healthier option.

Can being strictly vegetarian or having a soy-based diet help lower the risks of heart disease?
No single food can provide all the nutrients your body needs. You can lower your risk of heart disease and its associated risk factors such as excess weight, hypertension, high cholesterol and diabetes by eating a healthy balanced diet that incorporates a variety of nutrient-rich foods. You can refer to the SHF Heart Smart Eating Plate on how to adopt a heart-healthier eating portion.