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The tool is mobile-friendly, easy to use, and designed for health awareness only. It does not replace medical advice. If results seem abnormal, consult a healthcare professional.
In recent years, vape and e-cigarettes have been widely promoted as a safer alternative to traditional tobacco smoking. Many users believe that vaping is harmless because it does not involve burning tobacco. However, medical research clearly shows that vaping can be just as harmful as normal cigarettes, and in some cases, even more dangerous.
As healthcare professionals continue to observe increasing lung and heart complications related to vaping, it is important to raise public awareness about the real risks behind this trend.
Vape or e-cigarettes are electronic devices that heat a liquid (commonly called e-liquid) to produce an aerosol that is inhaled into the lungs. This aerosol is often mistakenly referred to as “water vapour,” but it actually contains multiple harmful substances.
Most e-liquids contain:
Many vape products deliver the same or even higher nicotine levels compared to tobacco cigarettes. Nicotine increases heart rate, blood pressure, and significantly raises the risk of heart attack and stroke. Addiction to nicotine also makes quitting extremely difficult.
Vaping has been linked to chronic cough, shortness of breath, chest pain, and a serious condition known as EVALI (E-cigarette or Vaping-Associated Lung Injury). Some cases have required intensive care and mechanical ventilation.
Studies show that vaping damages the lining of blood vessels, increases inflammation, and promotes clot formation. These effects significantly raise the risk of cardiovascular disease, similar to traditional cigarette smoking.
Vape aerosols contain toxic substances such as formaldehyde, acrolein, and benzene. Long-term exposure to these chemicals can damage lung tissue and increase cancer risk.
Nicotine exposure negatively affects brain development, particularly in teenagers and young adults. It can impair memory, concentration, and increase the risk of anxiety and mood disorders.
Although vaping is often marketed as a smoking cessation aid, major health organizations do not recommend it. Many users become dual users, continuing to smoke cigarettes while vaping, which increases overall health risks.
Safer and proven smoking cessation methods include:
Vaping is not harmless.
Vaping is not safe.
Vaping causes real and serious health damage just like tobacco cigarettes.
The delivery method may differ, but the long-term consequences to the lungs, heart, and brain are significant.
Disclaimer: This article is for educational and awareness purposes only and does not replace professional medical advice.
A look at the stark contrast between the Chola legacy and the modern struggle of Tamilians in Malaysia as depicted in a viral comic strip.
We often hear the phrase "We are the grandchildren of kings," but a recent comic strip circulating online forces us to ask: Are we living like it? The artwork presents a brutal juxtaposition between the "Prideful Cholas" of the 11th century and a satirical, darker depiction of modern Malaysian Tamils, labeled in the comic with the derogatory slang Mayirandiss (implying "useless" or "wretched people").
Let’s break down the details of this comic and the powerful, albeit painful, differentiation it makes.
The Top Panel: The Era of Pride (1000 Years Ago)
The top half of the comic takes us back to the Golden Age of Tamil history, specifically the reigns of Raja Raja Chola and his son, Rajendra Chola.
The Vision: The scene opens with a young Rajendra marveling at the Thanjavur Big Temple (Brihadisvara Temple). His father, Raja Raja Chola, teaches him a crucial lesson: "We pass on, but our legacy remains." This sets the tone for a civilization focused on creating things that outlast their own lifespans.
The Execution: Fast forward 15 years, and we see the famous Chola naval expansion into Southeast Asia (Kedah, Srivijaya). The grown-up Rajendra shows his father the "greatest fleet," declaring, "The ocean is ours!"
The Bond: The section ends with a wholesome embrace. The pride here is derived from achievement, construction, and expansion. The father is proud because his son has built something greater than himself.
The Bottom Panel: The Modern Reality (Malaysia Context)
The bottom half shifts to a gritty, sepia-toned modern setting, likely a neighborhood in Malaysia, where the dialect switches to a mix of Tamil and Malay ("Bang," "Jangan," "Pasal").
The "Legacy": Instead of discussing temples or empires, two mothers argue on the street. One boasts, "My son is a 77 number man!" (referencing the notorious "Double Seven" gang or similar secret societies). The other counters that her son is a "Hero." Here, pride is derived from criminal affiliation rather than achievement.
The Aggression: We see two young men posturing. There is no naval fleet to command, only a petty street confrontation involving a parang (machete). The dialogue captures the fragility of their egos: "What are you looking at? I'll break your eyes."
The Fall: The final scenes are tragic. A man begs a police officer, "Don't brother, I have a child," but it is too late. The officer counts down—citing "39 prior cases"—before the inevitable gunshot. The "legacy" left behind here is not a temple, but a fatherless child and a criminal record..
PUTRAJAYA, 18 December 2025 — Malaysia recorded a total of 198,992 deaths in 2024, according to the Department of Statistics Malaysia (DOSM).
The proportion of medically certified deaths increased from 60.7% (119,652 deaths) to 67.3% (133,844 deaths) in 2024.
Ischaemic Heart Diseases continued to be the main cause of death in Malaysia in 2024.
The data was published in the Causes of Death Statistics, Malaysia 2025 report using the International Classification of Diseases (ICD-11) by the World Health Organization (WHO, 2022).
Malaysia is among the earliest countries in the Asia-Pacific region to publish cause-of-death statistics using ICD-11.
Deaths caused by cancer increased significantly over time:
Main cancer-related causes in 2024:
According to the Ministry of Health Malaysia, Ischaemic Heart Diseases occur when blood vessels become hardened and narrowed due to cholesterol plaque.
Main risk factors include:
Pneumonia-related deaths were influenced by post-pandemic effects, especially among individuals with weakened immune systems and existing health conditions.
Ischaemic Heart Diseases were the main cause of death in 13 states. Pneumonia was the main cause in Perak, Sabah, and Sarawak.
States with the highest Ischaemic Heart Disease deaths:
Malaysia ranked 1st globally in the Open Data Inventory (ODIN) 2024/25, surpassing 197 countries. This marked a significant rise from 67th place in 2022/23.
Data access portal: https://open.dosm.gov.my
Source: Department of Statistics Malaysia (DOSM)
This article is for information and public awareness purposes only.
Your Liver and Your Heart: The Vital Link Most People Miss When we think about heart disease, we usually focus on cholesterol, blood pressure, or clogged arteries. But there’s a silent partner in cardiovascular health that rarely gets the spotlight, your liver. Yes, that hardworking organ tucked beneath your ribs doesn’t just detoxify your blood or digest fats, it plays a crucial role in heart health. In fact, liver problems can raise your risk of heart disease, and vice versa. Let’s explore this powerful connection. 1. The Liver: Your Body’s Lipid Lab Your liver manufactures, processes, and removes cholesterol and triglycerides, the fats that circulate in your blood. When your liver is healthy, it keeps these levels in balance. But if the liver is damaged (e.g., by fatty liver disease, alcohol, or viral hepatitis), it can: Overproduce triglycerides Lower “good” HDL cholesterol Release more “bad” LDL particles into your bloodstream This imbalance is a major driver of atherosclerosis, the buildup of plaque in arteries that leads to heart attacks and strokes. 2. Fatty Liver Disease & Heart Disease: A Dangerous Duo Non-alcoholic fatty liver disease (NAFLD), now often called MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), affects up to 1 in 4 adults. It’s strongly tied to: Obesity Insulin resistance Type 2 diabetes High blood pressure These are also key risk factors for heart disease. In fact, people with fatty liver are 2–3 times more likely to develop cardiovascular disease, even if their liver enzymes appear “normal.” Why? Because a fatty liver doesn’t just store fat, it releases inflammatory substances and free fatty acids that damage blood vessels and strain the heart. 3. The Heart Can Hurt the Liver Too It’s not a one-way street. Heart failure can lead to congestive hepatopathy (sometimes called “cardiac cirrhosis”). When the heart can’t pump effectively, blood backs up into the liver, causing: Swelling Reduced liver function Scarring over time So poor heart health can literally congest your liver, another reason to care for both organs together. 4. Shared Risk Factors = Shared Solutions The good news? What’s good for your heart is usually good for your liver, and vice versa: Lose excess weight (even 5–10% helps) Eat whole, unprocessed foods (think veggies, fiber, healthy fats) Limit sugar and refined carbs (they drive fat buildup in both liver and arteries) Exercise regularly (improves insulin sensitivity and fat metabolism) Avoid excessive alcohol (protects both organs) Manage blood sugar and blood pressure
5. Get Screened - Don’t Wait for Symptoms Liver disease often has no obvious symptoms until it’s advanced. If you have risk factors for heart disease (like high cholesterol, diabetes, or metabolic syndrome), ask your doctor about: Liver enzyme tests (ALT, AST) Ultrasound or FibroScan for fatty liver Monitoring triglycerides and HDL Early detection of liver issues could be a wake-up call to protect your heart too. Final Thought: Think "Heart-Liver Axis"
Your body doesn’t work in silos. The heart and liver are metabolic partners, and when one struggles, the other often follows. By caring for your liver through smart lifestyle choices, you’re not just preventing cirrhosis, you’re building a stronger, more resilient heart. Your liver filters your blood. Your heart pumps it. Together, they keep you alive, so treat them as a team. Disclaimer: Always consult a healthcare provider for personalized advice. References Rinella, M. E., & Lazarus, J. V. (2023). MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease): A New Nomenclature for Fatty Liver Disease. Journal of Hepatology, 79(6), 1686–1693. https://doi.org/10.1016/j.jhep.2023.08.027 American Heart Association. (2024). Heart Disease and Stroke Statistics—2024 Update. Circulation, 149(1), e1–e152. https://doi.org/10.1161/CIR.0000000000001209 Targher, G., Byrne, C. D., & Lonardo, A. (2022). Nonalcoholic Fatty Liver Disease and Risk of Cardiovascular Disease. Metabolism, 137, 155317. https://doi.org/10.1016/j.metabol.2022.155317 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2023). Nonalcoholic Fatty Liver Disease & NASH. https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash Møller, S., & Bernardi, M. (2020). Interactions Between the Heart and the Liver. European Heart Journal, 41(33), 3153–3160. https://doi.org/10.1093/eurheartj/ehaa377
Below is a clean, nursing-friendly explanation of ECG arrhythmia samples, identification, and interpretation, along with sample ECG images for educational use in Cath Lab settings.
Sudden cardiac arrest (SCA) remains one of the leading causes of mortality worldwide. Unlike a myocardial infarction (heart attack), which is caused by blocked coronary arteries, sudden cardiac arrest is an abrupt loss of heart function due to electrical instability, often occurring without warning.
The image above highlights a holistic classification of SCA causes, divided into three major categories:
This blog post breaks down each of these components in detail, making it easier for clinicians, students, and the public to understand the pathophysiology behind SCA.
🟥 1. Primary Ischemic Causes
Ischemia—lack of oxygenated blood—remains the most common trigger of sudden cardiac arrest. Any interruption in coronary blood flow can lead to ventricular arrhythmias such as ventricular tachycardia (VT) or ventricular fibrillation (VF).
1. Atherosclerotic Coronary Artery Disease (CAD)
The most frequent cause of SCA worldwide. Plaques can rupture, causing thrombosis and severe ischemia. Even before complete occlusion, plaque instability can lead to fatal arrhythmias.
Blood clots, valve vegetations, or debris may obstruct coronary arteries. These events are less common but often dramatic, rapidly compromising myocardial perfusion.
3. Spontaneous Coronary Artery Dissection (SCAD)
Seen more often in young women, especially postpartum. A tear in the arterial wall restricts blood flow and may lead to fatal arrhythmias.
4. Coronary Artery Spasm (Prinzmetal’s Angina)
Intense vasospasm can momentarily stop blood flow, triggering life-threatening arrhythmias even in individuals with no structural coronary disease.
5. Anomalous Origin of Coronary Artery
Congenital variations, especially arteries arising between the aorta and pulmonary artery, can be compressed during exertion, causing ischemia and SCA—particularly in young athletes.
🟩 2. Primary Structural Causes
Structural abnormalities change the heart’s anatomy, affecting its ability to pump effectively and maintain normal electrical conduction.
1. Hypertrophic Cardiomyopathy (HCM)
A leading cause of SCA in young individuals. Septal thickening creates an arrhythmogenic substrate, especially during exercise.
Ventricular enlargement leads to poor contractility and increased risk of sustained VT or VF.
Severe obstruction to left ventricular outflow raises wall stress and oxygen demand, predisposing the heart to sudden arrhythmias.
Even after surgical repair, patients may retain scar tissue or abnormal conduction pathways that predispose them to SCA.
A massive PE can trigger acute right ventricular failure and pulseless electrical activity (PEA).
Fluid accumulation in the pericardial sac restricts cardiac filling, leading to collapse of cardiac output and arrest.
7. Arrhythmogenic Right Ventricular Dysplasia (ARVD / ARVC)
A genetic disorder where the right ventricle is replaced by fatty and fibrous tissue. Causes malignant arrhythmias, especially in young athletes.
🟦 3. Primary Electrical Causes
Electrical disorders disrupt the heart’s rhythm without necessarily affecting its structure.
- Hyperkalemia → slows conduction, may cause asystole
- Hypokalemia → increases risk of VT/VF
- Hypomagnesemia → associated with torsades de pointes
- Disturbances in Na⁺, K⁺, Ca²⁺, Cl⁻ can destabilize cardiac myocytes.
Examples include:
These drugs alter conduction, repolarization, and may cause fatal arrhythmias.
3. Idiopathic Ventricular Tachycardia
Originates without identifiable structural or ischemic causes. Although sometimes benign, it can degenerate into VF.
Inherited or drug-induced. Prolonged repolarization increases risk of torsades de pointes and sudden death.
5. Brugada Syndrome
Genetic sodium channel disorder commonly presenting with ST-segment elevation in V1–V3. A major cause of SCA in Southeast Asian men.
6. Conduction Abnormalities
Advanced AV block or bundle branch block can lead to bradyarrhythmias and pulseless arrest.
7. Pre-excitation Syndromes (e.g., WPW)
Accessory pathways allow rapid conduction, leading to re-entrant tachyarrhythmias that may deteriorate into VF.
8. Commotio Cordis
Blunt chest trauma at a critical moment in the cardiac cycle triggers VF. Often seen in sports such as baseball or martial arts.
🟨 The Central Message: Rapid CPR Saves Lives
In the centre of the image is a reminder of the most critical step in cardiac arrest management:
Immediate, high-quality CPR.
Regardless of the underlying cause, early:
Chest compressions
Defibrillation (when appropriate)
Advanced cardiac life support (ACLS)
dramatically improves survival chances.
🫀 Why This Knowledge Matters in the Cath Lab
As Cath Lab professionals and emergency care providers, understanding these causes helps in:
✔ Rapid identification of ischemic vs non-ischemic etiologies
✔ Preparing appropriate interventional strategies
✔ Recognizing high-risk patients before they arrest
✔ Improving team readiness and ACLS response
SCA is not always caused by coronary occlusion. A broad differential saves lives.
References (Legitimate Medical Literature)
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2018 AHA/ACC/HRS Guideline for the Evaluation and Management of Patients With Cardiac Arrhythmias. Circulation.
Myerburg RJ, Junttila MJ. Sudden Cardiac Death Caused by Coronary Heart Disease. Circulation.
Maron BJ, Maron MS. Hypertrophic Cardiomyopathy. Lancet.
Priori SG, Blomström-Lundqvist C, et al. ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.
Virani SS et al. Heart Disease and Stroke Statistics—American Heart Association 2023 Update.
Sommariva E, Brugada R. Brugada Syndrome: Genetic and Clinical Insights.
Hayes BD, et al. Toxicologic Causes of Cardiac Arrest. Emerg Med Clin North Am.