Coronary Heart Disease in Malaysia: Symptoms, Treatments & Preventions

Our heart is the most significant organ in the human body. It pumps continuously from the beginning of our lives and does not even stop beating in our sleep. As a matter of fact, the heart pumps nearly a million amounts of blood in an average life expectancy.

Technically, the heart works like an engine for the human body. The heart is so important that all other organs can be affected if the heart breaks down.

In accordance with the latest data published in 2020 Coronary Heart Disease Deaths by WHO, Malaysia has reached 36,729 (21.86%) total deaths. Malaysia has also ranked 61st in the world with the age-standardized Death Rate of 136.21 per 100,000 population.

The commonness of heart disease in Malaysia is increasing over the years. What is typically known as the disease of the elderly can now be seen at earlier ages. Today, Malaysians in the age range from the early 20s to late 30s mostly suffer from heart problems. 

About 1 in every 4 deaths are caused by heart disease. On average, about 140 individuals for every 100,000 people will suffer from a heart attack in their lives.

What is heart disease?

Heart disease happens when the heart muscle or known as the myocardium, does not receive or severely reduced of blood supplies. 

This resulted when one of the coronary arteries, which contribute blood supplies to the heart muscle, is stopped by a blockage, like a blood clot that formed due to atherosclerosis. This consequence is called coronary thrombosis or coronary occlusion.

Types of heart disease

Heart disease consists of a list of conditions. The most common type of heart disease are:


This occurs when your heart does not receive much blood supply needed due to blockage to one or more of the arteries.

Angina is not considered a heart attack but more of a sign that you are at risk of a heart attack, cardiac arrest, or even sudden cardiac death.


If you’re diagnosed with an arrhythmia it means you have abnormal heart rhythm. Your heartbeat can either beat faster (tachycardia) or slower (bradycardia) than the regular 60 to 80 BPM (beats per minute).

Heart attack

Do not confuse this with cardiac arrest, as a heart attack can take place when the heart’s blood supply is decreased or not received any supply at all.

The coronary arteries could be narrowed by a plague which is formed by a combination of cholesterol, fat substances, calcium, cellular waste products, and blood-clotting substance.

Cardiac arrest

Cardiac arrest is not similar to a heart attack, although the terms are frequently used correspondently and sometimes, every so often, wrongly.

This occurs when the heart suddenly and unexpectedly stops working. It usually caused by abnormal heart patterns such as ventricular fibrillation but it can also be occurred by few other causes like coronary heart disease, congenital heart disease, heart attack, electrocution, or recreational drug use.


The symptoms of heart disease differ depending on what type of heart disease you are diagnosed with. The symptoms are:

Symptoms of heart disease in your blood vessels

A clog up of fatty plagues in your arteries, or known as atherosclerosis can harm your heart and blood vessels. Plagues building up can cause confined or blocked blood vessels which leads to a heart attack, aching chest (angina) or stroke.

Symptoms or coronary artery disease may varies for men and women. For example, men are more likely to have symptoms of chest pain while women are more likely to experience other signs along with chest discomforts like shortness of breath, extreme fatigue, and nausea.

Signs and symptoms include:

  • Chest pain, tighten chest, pressure on chest and chest discomfortness (angina)
  • Shortness of breath
  • Ache, numbness, chills, or weak legs or arms if the bloof vessels of the body parts are confined
  • Aching neck, throat, jaw, upper abdomen or back

You may not be diagnosed with coronary artery disease up until you experience a heart attack, angina, stroke or collapsed heart. Cardiovascular disease can be found early with regular checkups every so often.

Symptoms of heart disease by abnormal heart patterns (heart arrhythmias)

Your heart might beat impulsively, unhurriedly or irregularly. Signs and symptoms of heart arrhythmia includes:


  • Flittering in your chest
  • Rapid heartbeat (tachycardia)
  • Slow-beating heartbeat (bradycardia)
  • Chest ache or discomforts
  • Dizziness
  • Lightheaded
  • Short breathing
  • Fall unconscious (syncope) or near fainting

Symptoms of heart disease caused by heart attack

Symptoms of a heart attack include:

  • Chest ache
  • Pain in other parts of your body, from chest to arms (commonly to the left arm, but can affect both), neck, jaw, and back
  • Dizziness or light-headed
  • Sweating
  • Shortness of breath
  • Nauseousness or vomiting 
  • Extreme feeling of anxiety
  • Coughing or wheezing


The chest pain is typically severe but to some people, they may experience minor pain like indigestion.

While the most often symptom in both men and women is pain in the chest. Women are more likely to have other signs such as shortness of breath, feeling or being sick, and aching back or jaw.

Symptoms of heart disease caused by cardiac arrest

As mentioned above, unexpected cardiac arrest is not similar to a heart attack, when the heart fails to be supplied with blood due to blockage. 

Although, a heart attack can periodically trigger an electrical disruption that leads to unexpected cardiac arrest.

Symptoms of unexpected cardiac arrest are instant and serious which include:

  • Collapse unexpectedly
  • No pulse detected
  • Not breathing
  • Lost consciousness


Every so often, other symptoms can happen before sudden cardiac arrest such as:

  • Chest pain
  • Shortness of breath
  • Becoming weak
  • Rapid-beating, flattering, or pounding heart (palpitations)


Be mindful that sudden cardiac arrest commonly happens unexpectedly.

Factors and causes

According to Heart Foundation of Malaysia, there are 4 major alterable factors of a heart disease:

Cigarette/Tobacco smoke

Tobacco use increases the risk of heart disease and heart attack:

  • Smoking cigarettes can harm the heart and blood vessels which leads you to the risk of heart conditions like atherosclerosis and heart attack
  • Nicotine causes blood pressure
  • The amount of oxygen in our blood can be reduced by the carbon monoxide from cigarette smoke
  • Secondhand smoke can also expose and increase the risk of heart disease, even for nonsmokers.

Based on NHMS 2019, more than 27,200 smoking-reated deaths in Malaysia are reported yearly, compared to the 32,000 casualty from COVID-10 recorded since the pandemic hit two years ago.

National Health and Morbidity Survey 2019. (2019). Shah Alam, Selangor: National Institutes of Health (NIH) Ministry of Health Malaysia.

High blood cholesterol

Unhealthy blood cholesterol levels can lead to heart disease and heart attack. Cholesterol is a fat-like substance made by the liver and also can be found in some foods. 

Our liver makes enough for our body’s needs, but we commonly get extra cholesterol from the foods we consume. When we consume more cholesterol than the body needs, the additional cholesterol can clog up the arteries, including those at the heart. 

This leads to narrow arteries which resulting less blood supply to the heart, brain, kidneys, and other parts of the body.

High blood pressure

High blood pressure is known as a major risk factor for heart disease. It happens when the pressure of the blood in the arteries and other blood vessels is too intense. If the high blood pressure is not controlled, it can harm your heart and other primary organs in the body, including the brain and the kidneys.

This medical condition is commonly known as the “silent killer” due to it occurs with no symptoms. The only way for you to acknowledge yourself if you have this condition is by measuring your blood pressure.

Physical inactivity

Lack of physical activity can lead to heart complications. It can also risk you of having other medical conditions such as obesity, high blood pressure, high level of cholesterol, and also diabetes. 

Diabetes mellitus

Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas which its purpose to help glucose move from the food you consume to the cells of your body to provide energy.

If you have diabetes and your body does not have enough insulin,  it can lead diabetes, which causes sugar to build up in the blood.


Obesity is basically excessive body fat. Obesity is correlated with higher levels of cholesterol and triglyceride and lower levels of cholesterol. Obesity can cause high blood pressure, diabetes, and also heart diseases.

Ways to prevent heart disease

If you find yourself diagnosed with coronary heart disease (CHD), you can seek aid from a doctor or health professionals, and simply make simple lifestyle changes to help reduce your risk of having further complications. 

There are things you can do to help with coronary heart disease (CHD):


There are many types of medicines that can be used to treat CHD. The purpose of these medicines is to reduce blood pressure or widen the arteries of your heart.

Some heart medicines will have side effects, so it may take some time to find the type that works for you. Discuss with a specialist to prescribe several options for you.

Blood-thinning medicines

Blood thinners are the kind that can help reduce the risk of heart attack by making your blood less dense to prevent it from clotting.

Common blood-thinning medicines are:

  • Low-dose aspirin
  • Rivaroxaban
  • Clopidogrel
  • Prasugrel
  • Ticagrelor


If you have high levels of cholesterol, cholesterol-lowering medicine or known as statins can be prescribed to you.

The purpose of statin is to block the avoid cholesterol to form and increase the number of low-density lipoprotein (LDL) receptors in the liver.

Common cholesterol-lowering medicines are:

  • Atorvastatin
  • Simvastatin
  • Pravastatin
  • Rosuvastatin

Not all statins are suitable for everyone, so you might need to conduct a trial and error with the medications until you find that suits you.


Beta-blockers are commonly used to prevent angina and treat high blood pressure. They work by preventing the effects of a certain hormones in the body, which slows down the heartbeat and improves blood flow.


Beta-blockers include:

  •  Atenolol
  • Bisoprolol
  • Metoprolol
  • Nebivolol


Nitrates are used to widen the blood vessels. Doctors and health professionals occasionally refer nitrates as vasodilators. Nitrates work by tempering down your blood vessels and letting blood flow more efficiently.

This decreases your blood pressure and relieves any heartache you’re experiencing. Nitrates are available in several forms, including tablets, sprays, and patches like glyceryl trinitrate and isosorbide mononitrate.

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors are often used to treat high blood pressure. Examples of ACE inhibitors are:

  • Ramipril
  • Lisinopril


If you’re prescribed with ACE inhibitors, you will be monitored while taking them. Basic blood tests will be needed to check on your kidneys to make sure they are working properly.

The reason is that ACE inhibitors have side effects such as dry cough and dizziness. This medication could also be resulting in blood supply problems to their kidney. Less than 1 in 100 people have this problem when taking them.

Angiotensin-2 receptor blockers (ARBs)

Angiotensin-2 receptor blockers (ARBs) work similarly to ACE inhibitors. They are used to lower blood pressure by blocking the angiotensin-2 hormone.

Mild dizziness is commonly the only side effect when taking this medication. They are usually prescribed as an alternative to ACE inhibitors as they do not cause dry coughs.

Calcium channel blockers

Calcium channel blockers also work to lower blood pressure by firming the muscles that make up the walls of the arteries. This can widen the arteries, and reduce blood pressure.

Examples of calcium channel blockers are:

  • Amlodipine
  • Verapamil
  • Diltiazem


Side effects of this medication are headaches and flushing face, but these are mild and decrease over time.


Diuretics or known as water pills, works by flushing excess water and salt from the body through urination.

Procedures and surgery

When your blood vessels are narrowed as the result of build-up atheroma (fatty components) or your symptoms cannot be contained by using medicines, interventional procedures or surgery may need to clear up or bypass blocked arteries.

There are some main procedures used to treat blocked arteries such as:

Coronary angioplasty

Percutaneous coronary intervention (PCI) or known as coronary angioplasty, balloon angioplasty, or transluminal coronary angioplasty (PTCA).

This planned procedure is for individuals with angina, or urgent treatment when signs and symptoms become unstable.

Coronary angioplasty is also performed as an emergency treatment during a heart attack. During the procedure, a small balloon is inserted to push the fatty tissue outward from the narrowed artery. This allows the blood to flow more efficiently.

Then a metal stent (a wire mesh tube) will be placed in the artery to hold it open. Drug-eluting stents can also be used for this procedure. Therese releases medicines to prevent the artery from narrowing again.

Coronary artery bypass graft

Bypass surgery or also known as coronary artery bypass grafting (CABG), coronary artery bypass surgery, or a heart bypass.

This procedure is for individuals whose arteries are narrowed or blocked. To undergo this procedure, a coronary angiogram will determine if you are suitable or not.

Heart transplant

Sometimes, when the heart is severely damaged and taking medicines are not effective, or the heart is unable to work and pump blood across the body (heart failure), a heart transplant may be needed.

A heart transplant is a procedure in which the individual’s damaged heart will be replaced with a healthy donor heart.


Besides medicines and surgeries, there are several ways you can reduce the risk of developing coronary heart disease (CHD) by making changes in your lifestyle which could lower your blood pressure and cholesterol levels.

A healthy, balanced diet

A high-fiber, low-fat diet is very recommended, which includes plenty of fresh fruits and vegetables and whole grains for 5 portions a day. 

Your sodium intake (salt) should have a limit and not eat more than 6g (0.2oz) a day as high salt intake can lead to blood pressure. 

There are two types of fat; saturated and unsaturated. Have a healthy diet by avoiding food that contains saturated fats. This can increase the negative cholesterol levels in your blood.

Foods that contain saturated fat includes:

  • Meat pies
  • Sausages and fatty cuts of meat
  • Butter
  • Ghee – a type of butter commonly used in Indian cuisines
  • Cream
  • Hard cheese
  • Lard
  • Cakes and biscuits
  • Coconut or palm oil-containing food


Anyhow, a balanced diet must have unsaturated fats, which to be proven of increasing levels of good cholesterol and help reduce blockages in the arteries.

Foods that contain unsaturated fat includes:

  • Fish oil
  • Avocados
  • Sunflower, olive, and vegetable oils
  • Nuts and seeds


You should also avoid too much sugar in your diet as it can increase your risk of getting diabetes, which is believed to be a significant chance of developing CHD.

Be physically active

Integrating a healthy diet with a regular workout routine is the best way of sustaining a healthy weight. Having a healthy weight decreases the chance of developing high blood pressure.

Exercise regularly can make your heart and blood circulatory system more systematic, lower cholesterol levels, and also keep your blood pressure at the right, healthy level. Having an exercise routine can also reduce the risk of having a heart attack.

The heart can be considered like a muscle, that can also benefit from a workout. A strong heart can benefit you by pumping more blood through the body with less effort.

Any cardio exercise such as walking, swimming, and dancing can make your heart work harder and keep it and yourself healthy.

Maintain a healthy weight

A general practitioner or practice nurse can suggest to you what your ideal weight is by correlating your height and build. On the other hand, find out your body mass index (BMI) by using a BMI calculator.

Stop smoking

If you are a smoker, it’s better to give up as it can reduce the risk of developing CHD.

Smoking is the main factor for individuals to develop atherosclerosis. It is also a factor in the majority of cases of coronary thrombosis in people under the age of 50.

It is proven that you are up to 3 times more likely to stop smoking successfully if you utilize NHS support together with stop-smoking medicines like nicotine patches or gum.

Reduce your alcohol intake

If you are a drinker, It is recommended for you to not drink and exceed the limits. Avoid binge drinking as it can increase the risk of a heart attack. 

It is recommended for alcohol consumers to:

  • Not to regularly drink more than 14 units a week
  • Skip your drinking over 3 days or more if you drink as much as 14 units a week

Keep your blood pressure under control

You are able to keep your blood pressure under control by eating a healthy diet low in saturated fat, working out regularly, and taking certain medications to maintain a low level of blood pressure if needed.

Your blood pressure levels should be under 140/90mmHg. If you find yourself with high blood pressure, ask a general practitioner to check regularly check your blood pressure.

Keep your diabetes under control

There’s a high chance you can develop CHD if you are diagnosed with diabetes. It is important for you to be physically active and maintain your weight and blood pressure so that you can manage your blood sugar level.

If you are diagnosed with diabetes, you should target your level of blood pressure under 130/80mmHg.


As we know, our heart is the most important organ out of all in our bodies. It is what keeps us working and no doubt, we tend to harm it unintentionally with our unhealthy ways of living. 

We can always watch out for signs and symptoms of heart diseases by frequently acknowledging our healthiness. But it does not mean we do not want to take care of ourselves. 

There are ways for us to treat, prevent and improve our health by seeking help from a doctor or health professionals,  taking certain medications, undergoing certain treatments and procedures, and also making life-changing steps to better our health.

Author : 

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Alief Zolkopli

Marketing Manager, Teman Malaysia

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