Greater awareness of world’s biggest killer can help chances of survival, says Dr Henry Fok, cardiologist at Hong Kong Adventist Hospital – Stubbs Road. Private hospital in Happy Valley has created Rapid Access Chest Pain Clinic, open 24 hours a day, which can treat patients within 10 minutes of arrival
Every second counts in a heart-related emergency. A delay of even a couple of minutes could be the difference between life and death in the case of cardiac arrest or other complications affecting this vital blood-pumping organ.
Coronary heart disease led to the deaths of an average of 10.6 people in Hong Kong each day in 2017, according to statistics from the Department of Health
Between 2008 and 2017, more than 30,000 Hong Kong patients have died because of the problem – with sudden deaths often occurring after people have shown few symptoms.
Those at higher risk of suffering heart attacks include people aged between 40 and 60, smokers, those with high blood pressure, diabetes, high levels of cholesterol or little physical activity.
Check out 10 key facts and figures to remember when dealing with cardiac emergencies which could help to increase awareness about – and the chances of surviving – an acute myocardial infarction (AMI), the medical name for a heart attack.
1. World’s Number 1 killer ...
Cardiovascular disease – which refers to a range of conditions, including narrowed or blocked blood vessels, which can lead to a heart attack – remains the leading cause of death worldwide.
In 2018, the World Health Organisation listed strokes and ischemic heart disease (a blockage of the arteries) as the world’s biggest killers – accounting for a combined 15.2 million deaths.
2. ... and Hong Kong’s Number 3 killer
In Hong Kong, heart attacks and coronary diseases come third in the list of causes of fatalities, after cancer and pneumonia, according to a 2018 survey by the government’s Department of Health.
Widely-known risk factors include a bad diet, lack of exercise and a sedentary lifestyle – traits not uncommon among many in Hong Kong.
3. Early diagnosis is crucial
Dr Henry Kok, a specialist in cardiology at Hong Kong Adventist Hospital – Stubbs Road, in Happy Valley, who has worked in emergency wards at Hong Kong public hospitals, says the goal is always to attend to patients suffering chest pains and provide an electrocardiogram (ECG) within 15 minutes of their arrival.
“It is important to diagnose heart attacks early,” Kok says.
4. Longer waiting times in public hospitals
However, in reality, the waiting time for patients to receive an ECG in a public hospital is closer to 30 minutes, he says.
“Because of the sheer number of cases that public hospitals handle, it can be difficult [to meet the goal].”
5. Benefits of more rapid treatment
Kok is part of Hong Kong Adventist Hospital – Stubbs Road’s newly created Rapid Access Chest Pain Clinic team, where members attend to – and test – patients with chest pains, tightness or discomfort within 10 minutes of their arrival – in accordance with the guidelines set by European and American medical organisations.
Many international medical studies have proved that the shorter a patient’s diagnosis time, the more positive the outcome of the treatment will be and the lower the death rate.
“If we can treat an AMI or myocardial heart attack early, we have a better chance of saving the patient, preventing future complications and heart failure,” Kok says.
The private hospital's Rapid Access Chest Pain Clinic does not provide accident and emergency services in the same way as public hospitals. Patients can gain a clear understanding of the different prices – and range of services they will given – prior to their treatments.
6. Imminent heart attack symptoms
Most heart and medical organisations, including the Mayo Clinic in the United States and the Heart and Stroke Foundation of Canada, highlight six imminent heart attack symptoms:
Chest discomfort (pressure, tightness, a squeezing or aching sensation, burning and heaviness) that may spread to the neck, shoulder and back
Nausea, indigestion, heartburn or abdominal pain
Shortness of breath
Lightheadedness or dizziness
You should consult a doctor immediately if you experience any of these symptoms.
7. Attacks can occur any time
Heart attacks can occur at any time.
This is why Hong Kong Adventist Hospital – Stubbs Road’s Rapid Access Chest Pain Clinic operates 24 hours, seven days a week, all-year round.
“If the patient is experiencing chest pains, discomfort or sweating, we refer them to our chest pain clinic,” Kok says.
“It’s not a physical clinic but a protocol. An ECG, conducted by our emergency specialist doctor who is on call from 9am to 9pm, will be arranged within 10 minutes.”
Outside those hours, the Clinic is manned by other experienced general practitioners, who are able to diagnose an acute heart attack.
8. Take all chest pains seriously
Not all chest pains indicate a cardiac problem. Some scares may be as innocuous as heartburn.
However, all chest pains and related discomfort should be taken seriously: arrhythmia (an irregular heart beat) can result in symptoms similar to those of a heart attack.
A heart that beats too slowly can lead to fainting or even sudden death.
Women, in particular, are encouraged to take cardiac symptoms seriously. The American Heart Association reports that, 64 per cent of women who die suddenly of coronary heart diseases showed no previous symptoms.
Some women have also suffered heart attacks without chest pain or pressure.
Women have also been historically misdiagnosed or have had their symptoms been dismissed when the tests are inconclusive.
9. Avoiding heart muscle damage
Kok says when symptoms of a heart attack are dealt with within two hours, permanent cardiac muscle damage can be avoided.
In once case, Kok referred a patient to Hong Kong Adventist Hospital – Stubbs Road’s Rapid Access Chest Pain Clinic while he was away on a speaking engagement in Macau.
“Our doctors gave him an ECG within five minutes of his arrival,” he says.
10. Unblocking of blood vessels
Fortunately, the patient did not suffer a severe heart attack.
Doctors put the patient the hospital’s special care unit, while Kok flew back as soon as possible to conduct an emergency angiogram – a diagnostic test that uses X-rays to take pictures of a person’s blood vessels.
“A vessel was blocked so I opened it straightaway, unblocking it in 20 minutes,” Kok says.
“I also fixed the other severely blocked vessels with stenting [metal or plastic tubes inserted inside the lining of a vessel to keep the passageway open] at the same time. I implanted six stents in total [in] three major vessels.”
“Most importantly, the patient was OK and we were able to discharge him after two days.”