HEART ATTACK LEADING CAUSE OF DEATH (Adapted from The Star 31st October 2019)

Heart attack remains the leading cause of death in Malaysia for the 14th year.

Ischaemic heart diseases, which occur when arteries of the heart cannot deliver enough oxygen-rich blood to the heart, continued to be the main cause of death in Malaysia last year with a total of 18,267 deaths or 15.6% of total deaths from various causes, the latest Statistics on Causes of Death in Malaysia released by the Department of Statistics Malaysia (DOSM) revealed.

It was the principal cause of death for males in Malaysia with 12,510 deaths (17.8%) while for females, the principal cause of death was pneumonia with 6,033 deaths (12.8%), it said.

Last year, 172,031 total deaths from various causes were recorded, an increase of 2.3% compared to 168,168 in 2017, it said.

“On average, 50 persons in Malaysia die of ischaemic heart diseases every day,” DOSM said in the statistics released yesterday.

According to the National Heart, Lung and Blood Institute in the United States, the most common type of ischaemic heart diseases is coronary heart disease (also known as coronary artery disease).

It is caused by the build-up of plaque inside the coronary arteries. The build-up can partially or totally block blood flow in the large arteries of the heart. The condition may be caused by disease or injury which affects how the arteries work in the heart.

Coronary microvascular disease is another type of ischaemic heart diseases which occurs when the heart’s tiny arteries do not function normally.

Risk factors include smoking, high blood pressure, high cholesterol, diabetes, being physically inactive, overweight or obese, and family history.

DOSM said ischaemic heart diseases were the principal cause of death in 90 administrative districts in Malaysia and the highest percentage was recorded in Petaling, Selangor (16.3%).

Urban areas recorded 12,101 cases, double that in rural areas (6,166 cases), it said.

Pneumonia was the principal cause of death in 48 administrative districts with the highest percentage recorded in Kota Setar, Kedah (17.8%).

The number of deaths due to ischaemic heart diseases in Malaysia in 2010 was 9,371 and the figures increased gradually through the years. The jump increased more prominently from 2016 to 2017 (13.9%) and from 2017 to 2018 (15.6%).

After ischaemic heart diseases, the second main cause of death last year was pneumonia (11.8%), followed by cerebrovascular diseases (7.8%), transport accidents (3.7%) and chronic lower respiratory diseases (2.6%).
On the main causes of death by age group, 4.8% of those aged 0 to 14 died of pneumonia and 20.4% of those aged 15 to 40 died in transport accidents.

The main cause of death among those above age 40 was ischaemic heart diseases: ages 41 to 59 (19.2%) and ages 60 and above (16.6%). 

Reference: TheStar.com.my

The question now is: CAN WE DO SOMETHING ABOUT THIS SO THAT WE DON'T END UP AS JUST ANOTHER STATISTICS?

The answer is YES, but HOW?

1. Early detection
2. Early intervention
3. Active prevention by modifying risk factors
4. Adopting a healthy lifestyle

EECP in Kota Kinabalu @ DamaiMedic Oasis Medi-Hub

What is EECP®️?
It stands for Enhanced External Counter Pulsation.



What is the difference between EECP®️ and ECP?
The technology of reversing heart ischemia without surgery by enhancing coronary collateral flow using external pneumatic lower limbs cuffs synchronized to the diastolic phase of cardiac cycle is generally known as ECP (External Cardiac Pulsation). EECP®️ is a registered trademark of a certain ECP machine marketed by the Vasomedical, Inc. In terms of form and functions, both are basically the same and the term EECP®️ and ECP are often used interchangeably.

How does ECP reverse heart ischemia?
This technology of pumping blood into the coronary arteries when the heart is in the relaxed phase has been developed since 1953 by the Kantrowitz brothers from Harvard University. They invented the IABP (Intra Aortic Balloon Pump) which has been refined over the years and still being used today to treat cardiogenic shock. This procedure is highly invasive and only highly skilled Interventional Cardiologists are qualified to perform this procedure.

However, due to IABP's effectiveness in improving the heart coronary blood flow, this concept of  'diastolic augmentation' has been modified from 'internal-IABP' to 'external-ECP' by Dr.Sarnoff and Dr. Birtwell to enable more people both healthy and sick, to have access to this technology to improve blood circulations to the heart, brain, kidneys and liver effectively.

The milking of of blood from the lower-limbs in a sequential manner from calf to thigh to buttocks are able to increase blood flow to the heart as much as 20-40%. EECP®️/ECP is able to increase blood flow to the heart and vital organs without any surgery, painlessly and without needles. ECP does so by compressing the lower limbs and buttocks using pneumatic cuffs effectively.


 Does it mean any massage machine that compresses the legs is able to achieve the same effectiveness as EECP?
No. Diastolic augmentation is only effective when the counter pulsation machine is able to generate a peak diastolic arterial waveform that is 1.5 to 2 times higher than the peak systolic arterial waveform. Thus the timing accuracy and the effective pressure transmission of the ECP machine are two vital features that make ECP therapeutic compared to an ordinary calf massage machine.

Why is it that I have never heard of ECP treatment before?
ECP is a disruptive innovation that could change the course of heart disease progression if the intervention is timely. The more ECP is proven to be effective in reducing the number of heart attacks, the less cases of heart bypass and angioplasty may be possible in the near future. If the medical facility you visit considers this scenario as a conflict of interest, you will most probably not hear of ECP being promoted. However, heart centers offering holistic heart treatment would have the ECP incorporated in their heart rehabilitation module.

To date ECP is available in more than 40 countries in the world. Now ECP is also available in Kota Kinabalu @ DamaiMedic Oasis Medi-Hub. You can call +6016-4117100 for more info about EECP/ECP therapy.

Who will benefit from ECP therapy? Those who have:

• Chest pain (stable angina)
• Known heart blockages
• Stenting and bypass surgery done previously
• Poor energy and easy fatigability
• High risk factor for diabetes, hypertension, hypercholesterolemia.
• Sedentary lifestyle (no exercise)
• Need for general well-being

If you have any of these conditions below, ECP is not advisable:

• Pregnant
• Arrhythmias
• Aortic Aneurysm
• Blood Pressure more than 180/110mmHg
• Pacemaker/ Defibrillator
• Pulmonary Hypertension
• Acute Decompensated Heart Failure
• Haemorrhagic Stroke
• Venous Thrombosis in Lower Limbs
• On Warfarin with INR >3.0
• Bleeding Disorders

What is the mechanism of ECP?
Well, let the Dr Wong Teck Wee, the Interventional Cardiologist explain:

What are the evidences to prove ECP therapy really works?
The European Society of Cardiology (ESC) has given the recommendation of Class IIa with Level of Evidence B in their clinical guideline for patients with Refractory Angina Pectoris.

Major EECP studies like IEPR2, MUST-EECP and PEECH Trial provide convincing evidences on the role of EECP in cardiovascular care.

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To view more research papers on the effectiveness of EECP Click Here