CURRENT HEALTH PROBLEMS IN MALAYSIA: “Cardiovascular Disease - Heart Failure” By: Shiraaj bin Mohd Rasol Siti Nooraini binti Mohamad Yusof

DEFINITION: Cardiovascular disease refers to the class of diseases that involve the heart or blood vessels (arteries and veins)* The No. 1 Fatal Disease in MALAYSIA and WHOLE world Mainly Heart Failure- Inability of cardiac output to meet the demand of the body *

CURRENT STATUS:

LIFE STYLE: Smoking: - Prevalence: 21% (1985) - 31% (2000) - aged 15 ≥ - total of (ext) 5 mil. smokers; 14 ciggarettes/day - “National Healthy Lifestyle Campaign”- 43% attempted to quit- majority failed source: Clinical Practice Guideline on Treatment of Tobacco Use and Dependence, 2003, Ministry of Health, Malaysia

LIFESTYLES: Food: - lack of awareness of importance of proper diet - Use of high risk factors; condensed milk, oil - National Healthy lifestyle campaign*: - ban fast food advertisements on children's television to curb obesity and diet-linked diseases - food manufacturer to label their products with calorie content charts source:* Sean Yoong, Associated Press Writer | March 5, 2007

LIFESTYLES: Exercise: - Inc. awareness at school level - more thorough physical education system - Benefits*: - Flexibility exercises such as stretching improve the range of motion of muscles and joints. - Aerobic exercises such as cycling, walking, running, hiking, and playing tennis focus on increasing cardiovascular endurance. -Anaerobic exercises such as weight training, functional training or sprinting increase short-term muscle strength. source:

ETIOLOGY 1) Heart attack - damaged heart muscle = “acute myocardial infarction” 2) Prolonged pumping against a chronically increased afterload – eg: during hypertension and stenotic valves

Heart Failure – Primary Defect Differential Diagnosis: 1) abnormal QRS waveform – “ stress test ” 2) echocardiography 3) characteristics enzyme released cardiomocytes – measurement of concentration in blood cardiac contractility ejection pressure reduced V of stroke volume

Compensated Heart Failure symphatetic activity contactility towards normal at kidneys, due to blood flow, it retain : -[salt] - V of water during urine formation blood V source: Human Physiology (International Student Association), Lauralee Sherwood

De-compensated Heart Failure = A point where heart could no longer pump normal stroke volume – DESPITE compensatory measure Result: 1) Forward Failure: failure of heart to pump adequate amount of blood to the tissues –lowered stroke V 2) Backward Failure: Blood unable to enter and leave blood dam up at venous system - “ congestive heart failure ”

Systolic VS Diastolic Failure Systolic = Decreased cardiac contractility Diastolic = Heart has trouble filling

HEALTH STATUS in MALAYSIA World leader in surgical gloves and catheters (rubber based) - most supplies are imported - Government encourages manufacture of more expensive and advanced equipment shortages in the number of doctors and other medically trained personnel – ‘quick-fix’ solution: recruitment of 1,000 foreign doctors + increased scholarship for medicine study abroad Ninth Malaysia plan ( ); - RM2.0 billion-spent on developing rural health services, an increase of more than 150% from R&D, that saw only RM28.9 million in the last five years, receive RM250.0 million. - Allocation for training has tripled.

THE END…. Thank you for your attention…