Understanding how mild chest discomfort, breathlessness, and fatigue are signs of something much more serious.
Dr Lim Chiao Wen, Consultant Cardiologist, Electrophysiologist and Internal Medicine Physician at Sunway Medical Centre Velocity (SMCV)
Heart disease remains one of Malaysia’s leading health concerns, with ischaemic heart diseases accounting for 15.1% of all medically certified deaths1. More concerning is that Malaysians experience heart attacks at an average age of just 58, nearly eight years younger than the global average2.
Despite this, many young adults tend to ignore early warning signs, assuming they are too young to develop heart issues, according to Dr Lim Chiao Wen, Consultant Cardiologist, Electrophysiologist and Internal Medicine Physician at Sunway Medical Centre Velocity (SMCV). “This delay in recognising symptoms can lead to missed opportunities for early intervention,” she warns.
This trend is especially worrying as non-communicable diseases (NCDs) such as diabetes, hypertension, obesity and poor lifestyle habits are becoming increasingly prevalent among younger Malaysians, making early awareness and timely detection more critical than ever – particularly when it comes to recognising the early signs of what many refer to as a “mini heart attack”.
Understanding Mini Heart Attacks & Recognising Symptoms
The term “mini heart attack” is commonly used to describe less severe forms of heart attacks, such as unstable angina and Non-ST Elevation Myocardial Infarction (NSTEMI). Unstable angina occurs when the heart receives insufficient blood due to partially blocked arteries, causing chest pain but without permanent damage. NSTEMI, on the other hand, involves actual heart muscle injury, although less extensive than a full-blown heart attack (STEMI), which results from a complete artery blockage and requires emergency intervention.
Common symptoms of a mini heart attack include chest discomfort, breathlessness, fatigue, nausea, dizziness, and pain that may radiate to the jaw, neck, arms or back.
“The subtle symptoms of a mini heart attack that many Malaysians tend to ignore include mild chest discomfort, breathlessness, and fatigue. These symptoms are often dismissed because they can be caused by many everyday factors such as stress, lack of sleep, or even indigestion.” – Dr Lim Chiao Wen.
She explains that identifying a mini heart attack can be difficult without medical assessment, as symptoms can be vague and easily mistaken for gastric issues or heartburn.
Why Mini Heart Attacks Are Dangerous
Many people associate heart attacks with intense chest pain, breathlessness, and collapse, but mini heart attacks often present with much milder or even silent symptoms. Because the symptoms are not as severe, individuals may delay seeking medical attention or dismiss them entirely, assuming they are not serious. Unfortunately, this lack of awareness can be dangerous, as even a mild heart attack means that blood flow to the heart has been temporarily blocked, causing damage to the heart muscle.
Despite the seemingly subtle symptoms, mini heart attacks can still lead to significant and lasting damage to the heart. When oxygen supply is interrupted, even briefly, the heart tissue can become scarred, weakening the heart’s ability to pump blood efficiently. Over time, this damage can contribute to chronic heart conditions such as heart failure, arrhythmias (irregular heartbeats), or reduced circulation to vital organs.
Moreover, people who experience a mini heart attack without realising it may not take the necessary precautions to prevent further cardiovascular issues, leaving them at a much higher risk of a major heart attack in the future. In fact, studies indicate that up to 50% of people who suffer a serious heart attack had previously experienced undetected mini heart attacks, meaning they missed a crucial opportunity for early intervention3.
Furthermore, a study reported by CNN revealed that approximately 42.4% of individuals who died of sudden cardiac arrest without prior knowledge of coronary artery disease showed signs of having had a prior silent heart attack4. These studies collectively underscore the significant prevalence of silent heart attacks and their potential to cause substantial heart damage, often going unnoticed until a more severe cardiac event occurs. The danger of mini heart attacks is further compounded by the fact that certain groups have a higher risk of getting it, including diabetic patients and the elderly, who often experience atypical or less obvious symptoms.
Are Malaysians More at Risk of Mini Heart Attacks?
Smoking and vaping continue to be major contributors to heart disease, as they cause inflammation, thicken the blood, and encourage clot formation that can restrict blood flow to the heart. Alarmingly, 19% of Malaysians aged 15 and above are smokers, while vaping prevalence has risen to 5.8% in 2023, according to the Ministry of Health5.
Equally concerning are poor dietary habits, which have long been common in the country but are now exacerbated by modern convenience-driven lifestyles. High consumption of fried foods, sugary drinks, and processed meats, alongside the practice of reusing cooking oil, has been linked to elevated cholesterol levels and plaque buildup in arteries, both of which significantly increase the risk of heart disease.
These risks are further compounded by sedentary lifestyles and risingobesity rates, as long hours of sitting and minimal physical activity gradually weaken the heart. Individuals with chronic conditions such as diabetes and hypertension face an even higher risk. According to the National Health and Morbidity Survey (NHMS) 2023, 15.6% of Malaysians are living with diabetes6, which significantly increases one’s risk of developing heart disease. Similarly, high blood pressure puts added strain on the heart and can lead to long-term arterial damage if left unmanaged.
While lifestyle and chronic conditions are well-known risk factors, there are also misconceptions about gender and heart disease. Dr Lim clarifies the misconception that post-menopausal women are more susceptible to heart disease, stating, “Pre- menopausal women have a lower risk due to the protective effects of oestrogen. However, after menopause, when oestrogen levels decline, women face the same risk as men.
Furthermore, women may report unusual fatigue, dizziness, or nausea rather than the classic crushing chest pain. Because of this, many cases go undiagnosed until more severe heart complications arise.” She adds that genetics also plays a significant role in the risk of heart disease for both genders. Recognising these factors, she encourages everyone to be proactive in managing their heart health, regardless of age, gender, or family history.
Managing and Preventing Mini Heart Attacks
Mini heart attacks can recur if the underlying risk factors, such as high blood pressure, high cholesterol, diabetes, smoking, obesity, and unhealthy lifestyles, are not well managed. Dr Lim explains that these conditions can continue to damage the arteries over time, increasing the likelihood of repeated episodes or even a more severe heart attack.
Treatment typically involves a combination of medications and procedures to restore proper blood flow and reduce future risk. Antiplatelet drugs and blood thinners are commonly prescribed, while more serious cases may require procedures such as angioplasty. However, medical treatment alone is not enough. Dr Lim emphasises the importance of pairing it with lasting lifestyle changes, including a heart- healthy diet, regular exercise, quitting smoking, stress management, and careful control of blood pressure and cholesterol.
A Wake-Up Call for Malaysians
Cardiovascular disease continues to affect more Malaysians at a younger age, driven by lifestyle habits, underlying conditions, and delayed medical attention. While symptoms of mini heart attacks may appear mild, they can signal more serious complications if left unchecked. Through regular screenings, timely intervention, and sustainable lifestyle changes, Malaysians can take proactive steps to safeguard their heart health and reduce the risk of recurrent or more severe heart events.
Sunway Medical Centre Velocity is located at Lingkaran SV, Sunway Velocity. For enquiries, please get in touch with +603 9772 9191 or email smcv-enquiry@sunway.com.my.
For more information on the health screening packages and other services, or to learn more about Sunway Medical Centre Velocity, visit: www.sunmedvelocity.com.my
