Published by BusinessToday

Heart diseases are serious medical conditions that, if undetected or untreated early, can lead to severe and sometimes fatal consequences. While there are various forms of heart disease, the two most prevalent in Malaysia are ischemic heart disease and stroke. Unfortunately, Malaysia has one of the highest rates of heart disease in the region, highlighting the critical need for comprehensive healthcare strategies.

According to the Department of Statistics Malaysia, ischemic heart disease was the leading cause of death in 2022, accounting for 17% of all fatalities. A separate report by the Health Ministry (MOH) revealed that approximately one-third (35.2%) of heart attack fatalities occurred in individuals under the age of 60. The ministry detailed the breakdown further, noting that 64.7% of fatalities involved individuals aged 60 and above, 30.9% in those aged 40 to 59, 3.7% in the 30 to 39 age group, and 0.6% in people under 30. The primary contributors to this alarming trend were identified as obesity and smoking habits.

Despite Malaysia’s relatively advanced medical treatments for heart disease, the healthcare system is sometimes overwhelmed. Public hospitals often struggle with long waiting times, while private hospitals offer state-of-the-art facilities at significantly higher costs. However, Malaysia is fortunate to have a robust healthcare system and a world-class heart institute to combat the growing burden of cardiovascular diseases.

To gain deeper insights into the nation’s heart health crisis and the efforts being made to address it, BusinessToday spoke with Professor Dato’ Sri Dr. Mohamed Ezani Md Taib, Group Chief Executive Officer of the National Heart Institute Holdings, better known as Institut Jantung Negara (IJN). Dr. Ezani shared valuable perspectives on the alarming statistics and highlighted IJN’s pivotal role in addressing this pressing issue.

The Genesis of IJN

The seeds of IJN were sown in the early 1990s, following an urgent need for dedicated cardiac care. Before IJN, heart surgeries were conducted exclusively at Hospital Kuala Lumpur (HKL), which struggled with limited resources — a single operating theatre, six ICU beds, and a six-to-eight-year patient waiting list. Patients often sought costly overseas treatments or, tragically, succumbed to their conditions.

Recognising the severity of the situation, a proposal led by Tan Sri Dato’ Dr. Yahya Awang and Tan Sri Dr. Robaayah Zambahari, with the support of then-Prime Minister Tun Dr. Mahathir Mohamad, called for the establishment of a dedicated cardiac hospital. IJN opened its doors in 1992, equipped with four operating theatres, four catheterisation labs, and a 30-bed ICU. “It was a transformative period,” recalled Dr. Ezani, who was part of the team that transitioned from HKL to IJN. “We worked tirelessly to reduce the waiting list, and by 1996, it had dropped to just over a year.”

Milestones in Innovation

IJN quickly established itself as a hub for medical innovation. In 1997, it performed Malaysia’s first heart transplant, a historic milestone that elevated its reputation globally. Other breakthroughs followed, including advancements in valve repair, minimally invasive surgeries, and the adoption of Thoratec IVAD mechanical heart systems — making IJN the first in the Asia-Pacific to implement such technologies, even ahead of Japan.

“We’ve always pushed boundaries,” Dr. Ezani explained. “Our focus on service excellence and complex case management has allowed us to pioneer treatments that attract international attention. In fact, our first minimally invasive surgery was done in collaboration with Stanford University, with their team learning alongside us.”

These achievements positioned IJN not only as a leader in Malaysia but also as a centre of excellence in the global cardiovascular community, attracting patients and collaborations from around the world.

Addressing Malaysia’s Heart Health Crisis

Despite its successes, IJN remains grounded in addressing Malaysia’s pressing heart health crisis. Heart disease continues to be the nation’s leading cause of death, driven by lifestyle changes, high-calorie diets, smoking, and sedentary behaviour. Alarmingly, about 35% of heart attack fatalities occur in individuals under 60.

Dr. Ezani highlighted the importance of tackling these challenges through a multifaceted approach. IJN has invested heavily in preventive medicine, establishing dedicated clinics focusing on cardiac risk factors and launching nationwide screening initiatives. These programs have reached over 70,000 individuals across 170 locations, identifying high-risk patients and providing early interventions to prevent severe outcomes.

“One recent case from our screening program detected a 99% arterial blockage in a symptomless individual,” shared Dr. Ezani. “Early detection saved his life, proving the value of such efforts. We are not just treating heart disease but actively working to prevent it.”

Expanding Capacity and Accessibility

As Malaysia’s population ages and cardiac cases rise, IJN is approaching maximum capacity. The Institute currently performs around 12,000 cardiology procedures and 4,500 cardiac surgeries annually, supported by 430 beds. To address growing demand, IJN is constructing a new block that will add 150 to 200 beds within two years, significantly enhancing its service capabilities.

IJN has consistently expanded its inpatient and outpatient services, reflecting its commitment to meeting the growing demand for specialised heart care. In 2023, IJN recorded over 338,000 outpatient attendances and 18,324 inpatient admissions, showcasing its robust capacity to handle diverse cardiac cases.