Core of the matter
“Coronary artery disease usually occurs as a ‘heart attack’ when one is above 60 years old, but due to unhealthy lifestyle practices, we are seeing more of such patients in their 30s.”
Dr Julian Tan
Interventional cardiologist, who treats heart disease using non-surgical or minimally invasive techniques
Years in practice 18
Heart attacks don’t just happen to old men.

What should people be most concerned about in your area of specialisation?

Coronary artery disease (CAD), or blockages in the heart arteries, as they can abruptly cut short the life of a man or woman in his or her prime.

At what age does it usually occur? Does it have a genetic component?

CAD usually occurs as a “heart attack” when one is above 60 years old, but due to unhealthy lifestyle practices, we are seeing more of such patients in their 30s. Some people have a genetic predisposition to developing it, especially if there is a family history of parents or siblings having it in their 40s (for males), or 50s for (females).

Can it be prevented or spotted early?

If the disease is not of the hereditary kind, then, yes, it can be prevented by going for early, regular heart screening and leading a healthy lifestyle – exercise, a moderate and balanced diet, and no smoking.

What are the symptoms?

The most common symptom is central chest pain, especially from exertion, which is relieved by resting. Another common, and late, symptom is loss of stamina, or breathlessness.

What is involved in the treatment?

First and foremost, CAD treatment must include taking medicines to control high blood pressure, high cholesterol and diabetes, if one suffers from those conditions. Second line treatments include coronary angioplasty – heart stenting – or even open heart surgery.

Heart stenting has the added advantage over surgery in that recovery time is almost immediate. There are no incisions or splitting open of the chest. A needle-sized puncture in the wrist does the job of fixing the blocked heart arteries.

What‘s the one thing people should know?

CAD can develop without symptom, rearing its ugly head only when a heart attack occurs. That is why early heart screening is important, especially if you have a family history of CAD.

Dr Julian Tan practises at The Heart Specialist Clinic, #14-10 Mount Elizabeth Medical Centre, 3 Mount Elizabeth. Tel: 6235-8733