HEART ATTACK the SILENT

KILLER
Dr. HENGKY GOSAL, SpPD-KKV, FINASIM
Intervention Cardiologist
Royal Progress Hospital

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Educational Background
• 2019 – AsiaPasific Cardioconnect CME. Ho Chi Minh City, Vietnam.
• 2017 - Thrombosis Management, Pudong, Shanghai, China.
• 2017 - Asan Medical Center Interventional Cardiology Training
Program (ACT Program), Seoul, Korea
• 2017 - Dobutamine Stress Echocardiography Workshop
• 2016 - Advanced Cardiovascular Life Support Course
• 2016 - AHA-BLS for Healthcare Providers Course
• 2015 - Interventional Cardiology Training. Heart Center. HPP
Malaysia
• 2014 - The Interventional Cardiology Training Program. Tam Duc
Cardiology Hospital, Ho Chi Minh City, Vietnam.
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• Clinical Attachment: Interventional Cardiology,
Heart Centre, HPP, Penang, Malaysia.
• Fellowship: Cardiology Division, Internal
Medicine Departement, Medical Faculty,
University of Indonesia, Jakarta
• Residency: Manado General Hospital, Sam
Ratulangie University, North Celebes, Indonesia.
• Medical School: Atma Jaya University, Jakarta,
Indonesia
 Practice Experiences
2018- now – Royal Progress Hospital, Jakarta, Indonesia
2015-2016 – Heart Centre HPP Penang, Malaysia
2008- now – Omni Hospital, Tangerang, Banten, Indonesia
2008-2013 – RSCM Hospital, Jakarta, Indonesia
2006-2007 – Sumber Waras Hospital, Cirebon, West Java, Indonesia
2000-2006 – Manado General Hospital, North Celebes, Indonesia
1998-1999 – Atma Jaya Hospital, Jakarta, Indonesia
1995-1997 – Dirgahayu Hospital, Samarinda, East Borneo, Indonesia
1992-1995 – Puskesmas Temindung, East Borneo, Indonesia
 HEART ATTACK the SILENT KILLER
• ILLUSTRATION
• FACTS
• HOW THE HEART WORK
• HEART ATTACK
• WARNING SIGN
• RISK FACTOR
• EARLY TREATMENT

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 ILUSTRASI

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 Deaths in Thousands
500 461
410
400

300 285 265

Males
200 Females

100 70 59 64
35 47 38
0
A B C D E A B D F E

A Total CVD D Chronic Lower Respiratory

B Cancer Diseases
C Accidents E Diabetes Mellitus
F Alzheimer’s Disease
Leading causes of death for all males and females (United States: 2004).
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Source: NCHS and NHLBI.
 52%

13%
17%
.4%
.5% 4% 6% 7%

Coronary Heart Disease

Stroke
Heart Failure
High Blood Pressure
Diseases of the Arteries
Defects Congenital Cardiovascular
Rheumatic Fever/ Other
Rheumatic Heart Disease

Percentage breakdown of deaths from cardiovascular diseases (United States:2004)

Source: NCHS and NHLBI.
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 1 000
900 872
800
Deaths in Thousands

700
600 555
500
400 325
300 267
200 165
130 139 80
78 96
100 16 15 46 49
5 3 4 4
0
<25 25-34 35-44 45-54 55-64 65-74 75-84 85+ Total

CVD Cancer

Cardiovascular disease deaths vs. cancer deaths by age (United States: 2004).
Source: NCHS and NHLBI.
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 How the Heart Works

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 The heart
• Is a muscle the size of a
clenched fist
• Is located behind the
breastbone
• Pumps about 100,000 times a
day
• Pumps about 7,600 litres of
blood per day

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 Atherosclerosis

Plaque

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 Heart attacks

 Blood flow through coronary arteries is blocked

 Vital blood supply to heart muscle is cut off
 About 70,000 heart attacks each year
 Victims can often recover if treated immediately

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 Warning signs of a heart attack

Chest discomfort (uncomfortable chest

pressure, squeezing, fullness or pain,
burning or heaviness)

Discomfort in other areas of the upper

body (neck, jaw, shoulders, arms, back)

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 Warning signs of a heart attack

Shortness of breath

Sweating

Nausea

Light-headedness

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 Warning signs of a heart attack
 If you are experiencing any of the warning signs of a
heart attack ….
 (021) 6511008 emergency number
IMMEDIATELY
 Stop all activity
 Take your normal dose of nitroglycerin (if prescribed)
 If you are experiencing chest pain, take one dose of
160-325mg of ASA.
 Rest until the EMS arrive
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 Risk Factors
for
Heart Disease

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 Risk factors you can’t control
• Age
• Gender
• Family history
• Ethnicity
• Prior stroke or TIA

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 Risk factors you can change
• Take your blood pressure medication as prescribed
• Understand and monitor your blood pressure
• Be smoke-free
• Maintain a healthy weight
• Maintain a balanced diet
• Get active
• Limit alcohol intake
• Manage stress
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 What you can do to lower your risk
• Know and control your blood pressure
• Know and control your blood cholesterol
• Manage your diabetes
• Maintain a healthy weight
• Eat a healthy diet
• Limit alcohol consumption
• Be physically active
• Be smoke-free
• Reduce stress

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 Heart Disease in the United States

• About 610,000 people die of heart disease in the United

States every year–that’s 1 in every 4 deaths.
• Heart disease is the leading cause of death for both men and
women. More than half of the deaths due to heart disease in
2009 were in men.
• CHD is the most common type of heart disease, killing
over 370,000 people annually.
• Every year about 735,000 Americans have a heart attack. Of
these, 525,000 are a first heart attack and 210,000 happen in
people who have already had a heart attack.

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 Early Action is Important
for Heart Attack
• Know the warning signs and symptoms of a heart attack so
that you can act fast if you or someone you know might be
having a heart attack. The chances of survival are greater
when emergency treatment begins quickly.
• In a 2005 survey, most respondents—92%—recognized chest
pain as a symptom of a heart attack. Only 27% were aware of
all major symptoms and knew to call 9-1-1 when someone
was having a heart attack.5
• About 47% of sudden cardiac deaths occur outside a hospital.
This suggests that many people with heart disease don’t act
on early warning signs.6

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ANGIOPLASTY/PCI STENTING

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