Why limb amputation is the dark side of diabetes many people don’t consider

A study led by principal investigator A/Prof Kavita Venkataraman from NUS Saw Swee Hock School of Public Health (SSHSPH) discovered that the risk of diabetes-related lower extremity complications (DRLECs) appears to be higher in Singaporeans compared to Westerners. A/Prof Venkataraman highlighted that it is not only elderly grandfathers who were likely to develop DRLEC; 13% of diabetics who developed the complications were below age 50 and the time it took for diabetes to progress to DRLEC is about 27 months. This is shorter than the average of about 31 months seen in older patients.

CNA also quoted A/Prof Andrew Choong, Consultant, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, who said that it is important for diabetics to undergo regular foot screening and surveillance as part of their treatment. He added that closed-toe, well-fitting shoes are a must and daily foot checks are encouraged.

小毛病大问题：冠心病 (Body SOS: Ischaemic heart diseases)

​Mediacorp Channel 8’s health programme, “Body SOS”, featured Asst Prof Lim Toon Wei, Senior Consultant, Department of Cardiology, National University Heart Centre Singapore (NUHCS) who elaborated on some of the common symptoms and risk factors for ischaemic heart disease, as well as precautionary measures.

Do your heart good

​The Straits Times quoted Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, National University Heart Centre Singapore (NUHCS), who commented that coronary artery disease can occur in adults who overwork, lead an unhealthy lifestyle and have medical conditions such as diabetes, hypertension and high cholesterol. On the topic of overwork, Prof Tan said achieving optimal work-life balance is key to preventing premature death from overwork. He added that it is not just the individual who needs to be aware of this, but trade unions and the government should also be collectively involved in workers’ health.

• Straits Times Online, 31 August 2021, Dangers of overwork: Long hours and stress can lead to heart attack and stroke

压力与心脏疾病 (Stress and heart diseases)

​In an interview with 96.3好FM, Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, National University Heart Centre Singapore, discussed the impact of stress on our heart health. Prof Tan shared that stress may have acute and chronic impact. When one is under intense pressure or extremely angry, a large amount of adrenaline will be secreted and may cause the person to be in a state of heart attack. Prof Tan explained that the mechanism of heart attack, in this case, is different from the usual forms of heart attack as while the person is experiencing sudden heart failure, the blood vessels are fine and are not suffering from blockage. Prof Tan added that when a person is under long term stress, they may develop depression and neglect their health.

流行性感冒与心脏 (Influenza and the heart)

Commentary by Prof Tan Huay Cheem, Senior Consultant, National University Heart Centre, Singapore highlighted that while the whole world’s attention is on the COVID-19 pandemic, one should not forget about the influenza virus. Prof Tan said that influenza and the common flu are two different things and one should not assume them to be the same. He highlighted that patients suffering from heart disease are vulnerable to influenza virus attack and the influenza virus may also exacerbate heart disease. Prof Tan emphasised the importance and effectiveness of the influenza vaccines available, and the possible side effects that might arise.

近10年发病个案虽激增七成 急性心脏病死亡率显著下降 (While the number of acute heart disease episodes increased by 70% over the past decade, the death rate has dropped significantly)

​Lianhe Zaobao quoted Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, National University Heart Centre, Singapore, who commented that the increase in acute myocardial infarction cases is mainly due to the ageing population. The mortality rate has actually decreased significantly in the past ten years and this could be attributed to the advancement in medical treatment and better control of hypertension among the public. Prof Tan pointed out that data also shows that the acute heart disease mortality rate has levelled off in the past few years, maintaining at about 8%, which is similar to other developed countries.

Why jabs are critical for those with chronic issues

​In an interview with Straits Times on why people with diabetes or cardiac conditions such as hypertension are more at risk of severe disease if they were to get COVID-19, Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, National University Heart Centre, Singapore commented that most of these patients tend to be elderly people who are severely ill with frequent and chronic comorbidities.  He explained that COVID-19 patients with underlying heart conditions are six times more likely to be hospitalised than those without any pre-existing conditions and that their mortality rate is also 10 times higher.

On why cancer patients are more at risk of developing severe disease and if they can be vaccinated, Prof Goh Boon Cher, Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore said that patients with cancers who are receiving immunosuppressive therapy like chemotherapy or bone marrow transplant have weakened immune systems that cannot mount an adequate response to viral infection.  Patients currently on active cancer treatment should consult their oncologists for the optimal timing of the vaccinations in relation to the cancer treatment.

医生，我怕血 (Doctor, I’m afraid of blood)

​Prof Ronald Lee, Senior Consultant, Department of Cardiology, National University Heart Centre Singapore, and Professor at Department of Medicine, NUS Yong Loo Lin School of Medicine, wrote a commentary on his experience with an elderly patient who was diagnosed with atrial fibrillation, a common heart condition that causes palpitations and abnormally fast heart rate. He recalled how he advised the patient to take an oral medication that may cause the side effect of bleeding, and the patient replied that she was afraid of blood after her husband died from a brain haemorrhage. After further consideration and discussion on her circumstances, he advised the patient to go for a surgical procedure called left atrial appendage occlusion, which eventually helped to stabilise her heart rate.

Actress-DJ warns against exercising after Covid jabs

​Asst Prof Yeo Tee Joo, Department of Cardiology, National University Heart Centre Singapore (NUHCS), said that NUH has not seen more exercise-related side effects from COVID-19 vaccination and overall, there was no change in the trend of such symptoms. He said that doctors would be concerned about cardiovascular, respiratory and neurological symptoms should one resume exercising right after being vaccinated. He advised the public to seek medical attention promptly if anyone develops any serious symptoms such as chest pains, palpitations, dizziness, nausea, shortness of breath, lethargy, weakness and body aches.

Health Matters – Cardiac Arrest During Sleep

​In an interview with CNA938, Asst Prof Seow Swee Chong, Director and Senior Consultant, Cardiac Electrophysiology and Pacing, Department of Cardiology, NUHCS discussed why someone could develop cardiac arrest during sleep and the common causes, such as coronary artery disease, structural heart disease, or genetic disorder that can cause rhythm disorder during sleep. He said that about half of all patients with heart attack present as sudden cardiac death.

What causes cardic arrest during sleep?

​Asst Prof Seow Swee Chong, Director and Senior Consultant, Cardiac Electrophysiology and Pacing, Department of Cardiology, National University Heart Centre Singapore explained that a cardiac arrest is different from a heart attack and about half of all heart attack cases present as cardiac arrest.  He shared that people who have sleep apnoea essentially choke in their sleep and when they wake up, the increased adrenaline in their system could trigger a cardiac arrest.

Asst Prof Pipin Kojodjojo, Head and Senior Consultant, Cardiology, Ng Teng Fong General Hospital and Senior Consultant, Department of Cardiology, National University Heart Centre Singapore cited a German study published in the European Heart Journal in 2000, which highlighted sudden death was most likely to occur between 8am and noon, much more than midnight and 6am.  He said: “We are better at screening now and have more sophisticated tool. There is more awareness and all national servicemen get ECGs in their pre-participation screening.”

• CNA938 - Health Matters, 30 July 2021, Cardiac Arrest During Sleep

星期天《粉tastic Talkshow》吃得开心 (Sunday粉tastic Talkshow - Happy Dining)

​In a radio interview, Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, NUHCS discussed food culture in different countries and how to eat happily to make life meaningful.

Singapore scientists raise $3.6M to develop personalized mitral valve bioprosthesis

​The report highlighted that SingValve, a newly-developed mitral valve bioprosthesis developed by NUHS clinician-scientists, mimics the appearance, form and physical properties of a human mitral valve. Led by principal investigator, A/Prof Theo Kofidis, Head and Senior Consultant, Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, and Associate Professor, Department of Surgery, NUS Yong Loo Lin School of Medicine, the team was awarded a translational grant of $4.9 million (US$3.6 million) from the National Research Foundation Singapore Central Gap Fund in May this year.

Don't do moderate or high-intensity exercise for a week: Experts

The Straits Times quoted Prof Tan Huay Cheem, Senior Consultant, Department of Cardiology, National University Heart Centre (NUHCS), who said that given the new knowledge of the risk of myocarditis occurring in young males after COVID-19 vaccination, it is prudent that exercise, particularly those of moderate to high intensity, be withheld for a week. He explained that this is because no one can predict who will develop myocarditis after vaccination, even if the incidence is low. Prof Tan added that high-intensity exercise includes circuit training, vigorous forms of weight training, and moderate activities done at a heart-pounding pace, such as sprinting or swimming longer distances.

Lianhe Zaobao and Channel 8 carried Prof Tan's comments that cardiac arrest in young people under the age of 30 is very rare. It is usually partly caused by structural problems of the heart and cardiovascular system, and sometimes caused by myocarditis related to epidemic virus infection.

Asst Prof Yeo Tee Joo, Consultant, Department of Cardiology, NUHCS and Dr Louisa Sun, Consultant, Infectious Diseases and Chronic Programme, AH were also interviewed. Asst Prof Yeo shared with Channel 8 that the general population is also at risk of developing myocarditis and some may have very little or no symptoms at all and will not see a doctor. As a result, the actual incidence rate is still unclear.

• The New Paper, 7 July 2021
• Lianhe Zaobao, Page 4, 6 July 2021
• Lianhe Zaobao, Online, 6 July 2021
• Mediacorp 8world, 6 July 2021
  
• Lianhe Wanbao, Page 4, 6 July 2021
• Shin Min Daily News, Page 4, 6 July 2021

叶伟麟副教授接任国大心脏中心总主任 (A/Prof James Yip takes over helm of NUHCS)

​Lianhe Zaobao noted that Prof Tan Huay Cheem has handed over the baton of Director, National University Heart Centre, Singapore (NUHCS), to A/Prof James Yip after more than 13 years of dedicated leadership. Report noted that Prof Tan has charted the growth of NUHCS in many ways, including strengthening manpower training and development of clinical programmes, instituting structured training programmes for trainees, nurturing a research ecosystem, and cultivating young clinician scientists. In 2017, he inaugurated the Western STEMI network in the Western region of Singapore, achieving the shortest door-to-balloon time for patients transfer to National University Hospital (NUH) and lowest STEMI mortality rates in Singapore.

• BioSpectrum Asia, 1 July 2021