01 Mar 2011
One moment he was sitting in his car waiting for the light to turn green. The next, everything went black. “As soon as I came round, I drove myself to the nearest Accident and Emergency,” said the then 38-year-old.
Doctors diagnosed Mr Woo Chen Sin, a former national youth water polo player and entrepreneur, with non-sustained ventricular tachycardia, an abnormally fast heart rhythm.
“Mr Woo was suffering from an underlying disorder of the heart muscle, in which the left heart chamber becomes enlarged and can’t pump blood as well as a healthy heart,” said Dr David Sim, Consultant, Department of Cardiology, National Heart Centre Singapore (NHCS).
“This made him more prone to the condition, but its exact causes are often unknown.” Seven years later in 2008, Mr Woo was diagnosed with end-stage heart failure, which is irreversible. He had to give up work, was plagued by constant headaches, and small exertions left him breathless.“Heart failure broadly refers to the inability of the heart to function as a pump,” said Dr Sim. “This means that the heart cannot pump enough blood to meet the body’s demand. Heart failure is the end point for a number of heart conditions – most commonly ischaemic heart disease (when blood supply to the heart is reduced) which damages the heart,” said Dr Sim.
In milder forms of heart failure, the heart cannot keep up during exercise, but pumps enough blood when the patient carries out normal activities. In advanced stages, the heart cannot supply enough blood to the body even while at rest.
Mr Woo is one of about 5,000 people in Singapore who are admitted to hospital with heart failure every year. The condition is more common in men than in women. “Risk factors include poorly controlled blood pressure, diabetes, high cholesterol, smoking as well as obesity,” said Dr Sim.
There is no cure for advanced heart failure as the damage done to the heart is usually irreparable. “For patients in the early stages of heart failure, we prescribe a cocktail of drugs in combination with lifestyle changes to decrease the risk of complications and dying,” said Dr Sim.
“For example, if heart failure is partly brought about by alcohol, we ask the patient to refrain from drinking and recommend taking medication.”
“Heart failure patients have to make major lifestyle changes and, sometimes, even stop work altogether,” said Dr Sim.
Some patients with advanced forms of the disease may benefit from an implantable cardioverter defibrillator, a device which monitors heart rhythms. If it senses dangerous rhythms, it delivers shocks.
“This is useful to prevent the heart from suddenly stopping in selected heart failure patients,” said Dr Sim.
Every year, about 30 patients with endstage heart failure come to NHCS, which is the only centre in Singapore to carry out heart transplants. Six to eight of them will need a device to support their heart and/or a heart transplant.
An improved device known as Heart Mate II was introduced here in 2009. It takes over the pumping function from the heart and comes with a much smaller pump. This device is more suitable for adults with a smaller build, such as Asians and women.
Mr Woo is preparing to receive a Heart Mate II, which will buy him time until a suitable donor heart is available.
“I was really surprised that patients with the Heart Mate II were able to lead normal lives,” said Mr Woo.
The man, now 47, hopes that with this device, he will be able to return to work while he waits for his transplant.
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