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Daily Express
2 days ago
- Health
- Daily Express
60-70pc patients require stenting
Published on: Sunday, June 01, 2025 Published on: Sun, Jun 01, 2025 By: Sherell Jeffrey Text Size: Dr Rowland simplifies the procedure by comparing stenting to plumbing. STENTING, which involves inserting a small tube into a blocked or narrowed vessel and open it to facilitate blood flow has become increasingly popular as an intervention procedure. Dr Rowland said roughly 60 to 70 per cent of patients with coronary artery disease require stenting, also known as Percutaneous Coronary Intervention (PCI). 'Patients typically present with unstable conditions where chest pain becomes frequent and severe, often accompanied by symptoms like difficulty breathing. We call this acute coronary syndrome or heart attack,' he said. As a Consultant Cardiologist, he has performed over 8,000 stenting procedures and in the process introduced several advanced techniques in East Malaysia, including intravascular ultrasound imaging, rotablation and shockwave lithotripsy for hardened blood vessels. With such technology available locally, Sabahans no longer need to fly to Kuala Lumpur or Singapore for the life-saving procedure. 'These advanced technologies have revolutionised how we treat coronary artery disease,' Dr Rowland told Daily Express. 'With rotablation, we can drill through severely calcified blockages that were previously impossible to treat. 'Shockwave lithotripsy allows us to break up hardened calcium deposits, while intravascular ultrasound gives us a cross-sectional view inside blood vessels to optimise stent placement.' The importance of this technology cannot be overstated as heart disease cases continue to rise in Sabah. 'Many patients present late, especially those from the interior where screening is not easily accessible. By the time they come to us, the only option is stenting because they have gone beyond the stage where medical therapy alone would help,' he said. Dr Rowland simplifies the procedure by comparing stenting to plumbing. 'Our heart has pipes (blood vessels) that can clog up. As interventional cardiologists, we are like professional plumbers. We try to open up narrowed vessels using micro balloons and then we put in a stent to support the structure,' he said. He said stenting is minimally invasive unlike bypass which requires open-heart surgery. 'We access the heart through blood vessels in the wrist or groin area by inserting a small catheter, connect it to the heart vessel and inject dye to see where the blockage is. A stent is then placed to open up the blockage. The injection of dye is called an angiogram, which provides an X-ray image of the heart vessels, while Angioplasty refers to the actual procedure of inserting a balloon or stent.
Daily Express
2 days ago
- General
- Daily Express
Many are not taking their heart health seriously: Expert
Published on: Sunday, June 01, 2025 Published on: Sun, Jun 01, 2025 By: Sherell Jeffrey Text Size: Dr Rowland showing how the heart works. CONSULTANT Cardiologist Dr Rowland Chin Wee Ming is convinced many Sabahans are taking their heart health for granted based on witnessing a steady increase in heart-related ailments. They start making drastic changes to their lifestyle only when the alarm bells go off – chest pains and discomfort when doing physical activity, pain spreading to the left arm, back or jaw, palpitations, fainting or difficulty breathing. When this happens the blockage in their arteries usually would have reached 70 percent or more, making intervention necessary, he said. 'Last year alone I handled between 6,000 and 7,000 cases, including outpatient clinic visits, inpatient care, emergencies and interventional procedures such as angiograms. 'I have seen a 40 per cent increase in my load over the last few months,' he said and attributes this to several factors, including greater awareness and improved referral systems from smaller hospitals like Keningau, Tenom, Sandakan and Tawau. But he believes much of what contributes to ischaemic heart disease – where blood vessels become narrowed or blocked due to calcification or fatty deposits – has to do with our changing lifestyles. 'Our lifestyle has been changing. We become more modernised and basically our diet quality has been reduced. We tend to eat more processed food, food which are high in carbohydrates or saturated fat.' Coronary artery disease remains the most prevalent heart condition he encounters in his practice at a leading private medical centre. This occurs when blood vessels in the heart becomes narrowed or blocked by cholesterol or plaque. 'I personally feel diet is very important. We must be very careful about what we eat. Nowadays we are busy that we do not have home cooked meals which are very important in maintaining a good, healthy heart,' he said. Besides, modern lifestyles also leave little time for exercise, while urbanisation has reduced available spaces for physical activity. Then there are the other factors like increasing rates of diabetes, hypertension, high cholesterol and smoking. Genetics also plays a role. Patients with family histories of heart disease often have cardiac issues at a younger age. He said a growing number cases lately have been women and younger aduilts, especially after the Movement Control Order period. 'As for women, I think it is due to post menopause or hormonal changes playing a role,' he said, adding that heart attack symptoms in women also often differ from men. 'Their symptoms are atypical. They do not present like men having the usual typical chest pain or difficult breathing. Women's symptoms can be subtle. 'Maybe a bit of numbness in the hand or gastric discomfort or tiredness that could be underdiagnosed.' He cited the case of a 40-year-old woman who was misdiagnosed elsewhere and who was later correctly diagnosed as having ischemic heart disease. 'Traditionally, women are said to be of less risk but it is changing. We cannot just assume that women will be low risk. We must take case by case,' he said. In fact, different groups of people may have different risks for heart disease based on their background. 'Ethnic background can also influence risk. I have been to West Malaysia as well and over there Indians have a higher risk and often at a younger age. In Sabah, the Kadazan Dusun and Bajau also. 'It could be due to increased incidence of diabetes and blood pressure due to lifestyle changes which also put them at higher risk. But this is not set in stone. We still have chance to reduce the risk,' he said. # Daily Express reached out to the State Medical authorities on the situation faced at the Sabah Heart Centre at QE2, but received no response. 60-70pc patients require stenting Stenting, which involves inserting a small tube into a blocked or narrowed vessel and open it to facilitate blood flow has become increasingly popular as an intervention procedure. Dr Rowland said roughly 60 to 70 per cent of patients with coronary artery disease require stenting, also known as Percutaneous Coronary Intervention (PCI). 'Patients typically present with unstable conditions where chest pain becomes frequent and severe, often accompanied by symptoms like difficulty breathing. We call this acute coronary syndrome or heart attack,' he said. As a Consultant Cardiologist, he has performed over 8,000 stenting procedures and in the process introduced several advanced techniques in East Malaysia, including intravascular ultrasound imaging, rotablation and shockwave lithotripsy for hardened blood vessels. With such technology available locally, Sabahans no longer need to fly to Kuala Lumpur or Singapore for the life-saving procedure. 'These advanced technologies have revolutionised how we treat coronary artery disease,' Dr Rowland told Daily Express. 'With rotablation, we can drill through severely calcified blockages that were previously impossible to treat. 'Shockwave lithotripsy allows us to break up hardened calcium deposits, while intravascular ultrasound gives us a cross-sectional view inside blood vessels to optimise stent placement.' The importance of this technology cannot be overstated as heart disease cases continue to rise in Sabah. 'Many patients present late, especially those from the interior where screening is not easily accessible. By the time they come to us, the only option is stenting because they have gone beyond the stage where medical therapy alone would help,' he said. Dr Rowland simplifies the procedure by comparing stenting to plumbing. 'Our heart has pipes (blood vessels) that can clog up. As interventional cardiologists, we are like professional plumbers. We try to open up narrowed vessels using micro balloons and then we put in a stent to support the structure,' he said. He said stenting is minimally invasive unlike bypass which requires open-heart surgery. 'We access the heart through blood vessels in the wrist or groin area by inserting a small catheter, connect it to the heart vessel and inject dye to see where the blockage is. A stent is then placed to open up the blockage. The injection of dye is called an angiogram, which provides an X-ray image of the heart vessels, while Angioplasty refers to the actual procedure of inserting a balloon or stent. Bypass solution for multiple blockages DR Rowland said stenting is not always necessary. 'If the disease is very mild or if patient is stable with no chest pain, he or she can often be treated with medications alone,' he said. Stenting might also be avoided for the elderly, frail patients or those with multiple medical conditions like stroke or kidney failure. 'For those with limited life expectancy due to age or conditions like cancer, medical therapy might be the better choice. Besides some patients may not be able to afford stenting and angioplasty. Every case must be evaluated individually,' he said, adding that financial considerations also play a role. While stenting technology has advanced significantly, bypass coronary artery bypass grafting is typically recommended when the patient has multiple vessel blockages. 'For instance, if all three vessels are totally blocked, especially at the origin of the left main vessel, we would recommend bypass,' he said. He said bypass surgery is also considered when blockages are too diffused or when the vessels are extremely hardened, making them unsuitable for stenting. This is particularly true for diabetic patients with multiple blockages. 'Bypass is a major operation performed by cardiothoracic surgeons. It is a full open-heart surgery where surgeons make a midline incision, open up the muscle and bone and expose the heart. 'They then take vessels from the leg and create bypasses around the blocked areas,' he said, adding the procedure can take about six hours under general anaesthesia. Patients may need to stay in hospital for a week or even a month. 'In contrast, stenting typically take between 30 minutes and two hours and patients can usually go home the next day,' he said. While Dr Rowland has treated patients of all ages, his youngest patient was an 18-year-old boy with high cholesterol and a heavy smoker. 'My youngest female patient was a 23-year-old, also a smoker with family history,' he said. His oldest patient was a 91-year-old male with multiple health issues. 'He had triple vessel blockage, along with cancer, kidney failure and lung problems. After assessment, I decided to fix the main vessel and he lived for another six or seven years. One of his most challenging cases involved a 40-year-old female athlete with no apparent risk factors. 'She had no diabetes, no hypertension, no high cholesterol, was a non-smoker and had no family history of heart disease. 'Yet she had one of the most difficult blockages I have ever treated. It was hardened, 100 per cent blocked, calcified and in a winding vessel,' he said. The procedure took seven hours, split into two sessions, four hours to cross the blockage and three hours for rotablation. 'It required multiple wires and devices, extreme patience and precision. 'We had to be very careful since the vessel was windy, push the wire too hard or in the wrong direction and you might burst the vessel. 'We had to feel it, apply the right force and try to find the right path. Thankfully she is now leading a healthy life,' he said. Stent technology has made great strides Stent technology has evolved since its introduction in the 1990s. 'Initially, we had bare metal stents with no medicine coating. This evolved into drug-eluting stents, which have medicine coated around them to reduce the risk of restenosis (re-narrowing),' said Dr Rowland. Recent innovations include bioabsorbable stents that dissolve after about a year, polymer-free stents that minimise inflammation and drug-coated balloons that do not require stent placement. 'With drug-coated balloons, for patients with soft plaque, we can inflate the balloon, squash the cholesterol and remove the balloon without leaving a stent behind. We have always believed that the patient's own vessel is the best and will last the longest. About 60 per cent of patients in KPJ will use this approach if the narrowing is very soft,' he said. Dr Rowland is proud of pioneering several techniques in East Malaysia. 'I started using intravascular ultrasound in East Malaysia, which is like a hair-like micro camera that goes inside the vessel to see what is there. 'This helps us optimise stenting and make procedures much safer,' he said. He also introduced rotablation in the private sector in 2017. 'Many patients in Sabah have hardened vessels that are difficult to treat with standard stenting. Rotablation, which is like drilling, can open up these vessels more effectively. We were trained by Japanese and Thai specialists and this technique has saved many lives,' he said. In 2020, Dr Rowland pioneered the use of shockwave lithotripsy in the State, with training from a specialist from Brunei. 'This is basically a balloon to open up hardened calcified plaque. Under my direction we pioneered all three - intravascular ultrasound, rotablation and shockwave lithotripsy,' he said. Successful stenting procedures require a well-coordinated team. 'A standard procedure needs at least one doctor (the interventional cardiologist), one scrub nurse to assist, one circulating nurse who gives medicine as needed and a radiographer. 'These are the bare minimum four, but usually we have five to six staff for each procedure to increase efficiency and safety,' he said. He credits his team for their dedication. 'My nurses are well-trained, dedicated and committed to patient care. They have the most patience in the world and they can really synchronize with me. With them, we can overcome the most difficult and seemingly impossible cases. 'I must thank my angiogram nurses and radiographer who have worked tirelessly with dedication to help me over the last 10 years since we started their angiogram service in 2014. 'Everything is about teamwork, not just one cardiologist,' he said. While stenting is generally very safe Dr Rowland acknowledges that complications can occur in rare instances. 'The risk of complications is very low, less than 0.01 per cent. Potential risks include vessel dissection or perforation, stent thrombosis, bleeding, heart attack during the procedure, stroke or kidney failure. 'That is why we are very careful. We use meticulous techniques, select patients carefully, and provide proper pre- and post-procedure monitoring to minimise these risks,' he said. 'I am proud that due to our team of nurses and our meticulous care, our risk is very minimum, maybe less than 0.01 per cent,' he said. Despite the advances in cardiac care, Dr Rowland noted that Sabah still faces a shortage of specialists. 'All three private hospitals in Kota Kinabalu can now perform stenting procedures. Queen Elizabeth Hospital also provides these services,' he said. However, he acknowledged the need for more trained cardiologists. 'We are still relatively understaffed in terms of cardiologists versus the demand. We need to train more local specialists to increase our capacity,' he said. For bypass surgery, options in Sabah are even more limited. Most cases are referred to Queen Elizabeth Hospital, which currently has only one cardiothoracic surgeon. What to watch out for: Chin THE most common heart conditions that cardiologists treat include coronary artery disease, heart rhythm problems, heart failure and valvular heart disease, where valves become leaky, fail to close properly or become too tight or narrow due to age. 'If a person previously fit cannot walk more than 15 minutes and experience chest discomfort or pain or difficulty breathing or if they go up two stories or two flights of stairs and have to stop and catch their breath, they should see a cardiologist already,' he said. He said atypical symptoms like jaw pain, numbness in the left hand, persistent stomach discomfort, leg swelling and inability to sleep at night could also indicate heart problems. 'Every successful treatment or procedure is not about opening a vessel. It is about giving back someone's parent or spouse or child. 'Even in terminal cases, we give emotional support and often find that medical therapy can make a significant difference. 'I always believe in prevention. Early detection is always better than cure and treatment because if you catch the disease early, it is not too difficult to treat. 'You need to have a healthy lifestyle. That means you have to have a balanced diet, low salt, low sugar, more vegetables, moderate amount of fruit and whole grain,' he said. He also recommends not smoking, remaining physically active with about 150 minutes of moderate exercise per week and controlling conditions like diabetes, high blood pressure and high cholesterol. 'For those who are well, an annual health checkup is advised, particularly for those with a family history of heart disease. 'If you are not careful with your diet, it will definitely contribute to early heart disease,' he said, recommending home-cooked meals where possible. Throughout his career, Dr Rowland has witnessed firsthand the difference that specialised cardiac care can make. He recalls a case in his early days when, without access to intervention facilities, he lost a patient with diabetes and chest discomfort despite a month of medical treatment. In contrast, when they gained access to an angio-cath lab, they were able to save a younger patient who had collapsed during football by performing an angiogram and inserting a stent. 'He woke up and he is still healthy and well to this day. That is the difference. 'I truly believe we have played a significant role in setting up the intervention service in Sabah, whereas in the past we did not have it,' he said. His dedication to medicine was shaped by his experience serving in Beaufort in 2000. 'I was exposed to the rural difficulty and tertiary care difference like that. That made me decide I want to do something rather than just be a General Practitioner,' he said. 'With my dedicated nurses, we improve our service, get new equipment. Whatever overseas have, we acquire them, learn them. And I sent my nurses for training. 'It is important for nurses to go for training, which a lot of hospital management must understand that is important,' he said. The family man with two children credits his success to a supportive network, including his dedicated nursing team, his understanding wife who supports him during long hours at the hospital and night calls, his children and his mother who always believed in him. 'For me, the most rewarding thing is to come back to Sabah, use my skills overseas and give back to the Sabah people and contribute to the interventional cardiology field in Sabah, provide world-class service. 'For me, to be able to save someone's parents or spouse or children is priceless,' he said. 'My journey is far from over,' he says, expressing his commitment to ensuring that more doctors can become world-class cardiologists and provide the best care to patients in Sabah. Top student owes it to Yayasan Sabah scholarship As one of Sabah's top students in the SPM exam in 1990, Dr Rowland Chin Wee Wing is a role model Sabah scholarship recipient. Rather than seize the opportunity to work abroad for higher remunerations, Roland decided he owes it to Yayasan Sabah for the opportunity to graduate as a cardiologist specialising in intervention procedures – a skill that is still considered new in Malaysia. In doing so he was also living up to his mother's expectations who wanted him to rise to as high as his career choice would let him. His mother told him 'you will be great one day'. Thirty years later, Dr Rowland found himself doing great things. He specialises in diagnosing and treating heart conditions, with particular expertise in interventional procedures that can save lives. Today, he is one of Sabah's leading cardiologists. 'I was born in Queen Elizabeth Hospital and always take pride in returning back to Sabah. I had many chances to migrate, especially to Australia but decided Sabah is my home,' said Dr Rowland. He praised the current hajiji-led State Government's emphasis on scholarships as it was this opportunity that allowed him to pursue his medical degree at the University of New South Wales, Australia, among the top 20 global universities. 'Without this scholarship, I would be a nobody. I had the chance to become someone because of this scholarship. 'That is why, I decided to come back and improve healthcare in Sabah using my skills,' said Dr Rowland, whose parents are from Sarawak. A consultant cardiologist for 20 years, his specialised training began in 2006 at Sarawak General Hospital under one, Dr Omar, as Sabah did not have a cardiac centre then. He then underwent training at Monash Medical Centre in Melbourne, where he gained expertise in handling complicated cardiac cases. He returned to Sarawak in 2009 before coming back to Sabah when the heart centre was being established. In 2012, Dr Rowland together with Dr Liew Houng Bang, set up the first independent intervention service at Queen Elizabeth Hospital, performing up to 1,000 angioplasties annually. In 2014, he helped set up the first independent intervention service at a private facility. Where stenting is concerned, he is among cardiologists who have done the most. 'Number is not important. What matters most is the quality of care. As long as a patient is safe, that is most important,' he said. 'What sets cardiologists apart from regular doctors is that we have the special skill and training to open up blood vessels. 'We can fix them within one or two hours and patients can potentially go back in the next few days. Last time they had to wait for one month or go to Kuala Lumpur, Singapore or Institut Jantung Negara.' Dr Rowland also does pacemaker implants for patients with slow heartbeats. 'When your heartbeat becomes very slow, we put in a battery to make your heart beat faster, this is called a pacemaker,' he said. Additionally, he conducts echocardiograms, which allow him to visualise how the heart beats, assess its strength and determine if there is heart failure.
Daily Express
27-05-2025
- Entertainment
- Daily Express
Petronas celebrates Kaamatan with heartfelt webfilm 'Tinorindak Olisi' (Crown of Love)
Published on: Tuesday, May 27, 2025 Published on: Tue, May 27, 2025 By: Sherell Jeffrey Text Size: KOTA KINABALU: In conjunction with this year's Kaamatan festival, Petronas has released Tinorindak Olisi (Crown of Love), a touching webfilm about finding triumph through love, cultural pride, and community support, rather than just titles. Set in Sabah and featuring the Dusun language, the film follows Elyna Jamis, a young Unduk Ngadau contestant, on a journey of self-discovery and resilience. 'In line with the theme 'Kaamatan for All', the film reminds us that true strength lies in unity and support,' said Petronas Senior GM of Strategic Communications, Siti Azlina A Latif. The film premiered under Yayasan Petronas' Uplifting Lives Festive programme, which reached 500 recipients in Sabah with essential aid. Deputy Chief Minister Datuk Seri Dr Jeffrey Kitingan and Siti Azlina personally handed over festive packs to selected families in Manggatal. 'Through this initiative, we honour traditions and strengthen community bonds while supporting those in need,' Siti Azlina added. Advertisement Directed by Ismail Kamarul, Tinorindak Olisi is available on Petronas' YouTube and Facebook channels. * Follow us on our official WhatsApp channel and Telegram for breaking news alerts and key updates! * Do you have access to the Daily Express e-paper and online exclusive news? Check out subscription plans available. Stay up-to-date by following Daily Express's Telegram channel. Daily Express Malaysia
Daily Express
27-05-2025
- Politics
- Daily Express
STAR aims to contest 15 seats
Published on: Tuesday, May 27, 2025 Published on: Tue, May 27, 2025 By: Sherell Jeffrey Text Size: Jeffrey having a light moment with the team from Petronas. - Sherell Jeffrey/Daily Express KOTA KINABALU: Star Sabah President Datuk Seri Dr Jeffrey Kitingan has revealed the party's aim to contest 15 seats in the upcoming 17th Sabah state election, nearly double the eight seats contested in 2020. He clarified that the number is aspirational, with formal seat negotiations amongst Gabungan Rakyat Sabah (GRS) coalition partners yet to begin. 'In politics, every party wants to contest all seats. There's nothing wrong with expressing intentions,' said Jeffrey at a Kaamatan event. Star Sabah won six out of eight seats in the 2020 election, the highest win rate among GRS parties. Jeffrey said ongoing discussions are happening with Parti Bersatu Sabah (PBS) and within the GRS bloc, but no final decisions have been made. He expects seat allocations to be resolved before the election but gave no firm timeline. Advertisement Other parties like PKR and DAP have announced plans to contest 13 and 10 seats, respectively, while GRS may field candidates in at least 52 constituencies. * Read full report in tomorrow's print paper or log in or sign up for e-paper and premium online news access. * Follow us on Instagram and join our Telegram and/or WhatsApp channel(s) for the latest news you don't want to miss. Stay up-to-date by following Daily Express's Telegram channel. Daily Express Malaysia
Daily Express
21-05-2025
- Daily Express
Woman, granddaughter killed in Manggatal fire
Published on: Wednesday, May 21, 2025 Published on: Wed, May 21, 2025 By: Sherell Jeffrey Text Size: Firefighters putting out the fire at the scene. Kota Kinabalu: A fire in Kg Pulau Penampang, Manggatal, claimed the lives of an 80-year-old and her 14-year-old granddaughter, Tuesday. Preliminary investigations showed the house was occupied by six people comprising a man and five women when the fire broke out at about 5.15am. Kota Kinabalu District Police Chief ACP Kasim Muda said a family member resting on the house's veranda heard an explosion coming from the kitchen area. The family member immediately noticed the kitchen was on fire and, together with other relatives, tried to put out the flames. However, the fire spread quickly, trapping the two victims. Early findings by the Fire and Rescue Department suggest that the fire may have been caused by an electrical short circuit, but further investigations are ongoing to determine the actual cause. Advertisement The Fire and Rescue Department said the fire involved a permanent house which was 90 per cent destroyed and a Perodua Axia parked nearby which was partly damaged. A total of 31 personnel from various agencies, including the police, Health Department and Sabah Electricity were deployed to the scene. Firefighters managed to control the blaze at 5.55am using two water jets and a water tanker. However, they were unable to save the two trapped victims. The remains of the elderly woman was found at 7.13am, followed by her granddaughter at 7.33am. Both bodies have been sent to Queen Elizabeth Hospital for post-mortem. Kasim urged the public to prioritise home safety, particularly regarding electrical wiring and appliance usage. 'Ensure electrical devices are turned off when not in use, avoid overloading sockets and conduct regular checks on home wiring systems,' he said. He also pointed out the importance of having fire extinguishers and emergency exit plans in place. * Follow us on our official WhatsApp channel and Telegram for breaking news alerts and key updates! * Do you have access to the Daily Express e-paper and online exclusive news? Check out subscription plans available. Stay up-to-date by following Daily Express's Telegram channel. Daily Express Malaysia
