Sejujurnya, kisah seperti ini bukan sekadar “kes berhasil”—ini adalah pengingat betapa tipisnya batas antara waktu dan nyawa. Kisah dari Batam.
Seorang pasien datang jauh dari Batam, menyeberangi laut dalam kondisi nyeri dada yang semakin memberat. Saat tiba, gejala yang dialaminya sangat khas untuk serangan jantung akut atau Infark Miokard Akut—suatu kondisi di mana aliran darah ke otot jantung terhenti secara tiba-tiba akibat sumbatan pembuluh darah koroner.
Dalam situasi seperti ini, waktu bukan lagi sekadar angka di jam. Setiap menit berarti jaringan jantung yang bisa diselamatkan—atau hilang selamanya.
Setelah penilaian awal dan konfirmasi diagnosis, kami segera membawa pasien ke cath lab untuk melakukan Angioplasti Koroner. Prosedur ini bertujuan membuka pembuluh darah yang tersumbat menggunakan balon kecil, diikuti dengan pemasangan Stent Koroner untuk memastikan aliran darah tetap lancar.
Prosesnya berjalan dengan fokus dan koordinasi tinggi. Dalam kondisi darurat seperti ini, setiap langkah harus cepat, tepat, dan terkoordinasi dengan baik. Tim cath lab, perawat, hingga dokter semuanya bergerak sebagai satu kesatuan.
Syukurlah, pembuluh darah yang tersumbat berhasil dibuka, dan aliran darah ke jantung kembali normal.
Namun, yang paling berkesan bukan hanya keberhasilan prosedurnya.
Hari berikutnya, saat melakukan review di wad, kami melihat pasien sudah bisa duduk, berbicara, dan—yang paling penting—tersenyum bersama keluarganya. Wajah yang sebelumnya penuh kecemasan kini berubah menjadi lega dan penuh harapan.
Perjalanan dari Batam bukanlah hal yang mudah, apalagi dalam kondisi darurat. Tapi keputusan untuk segera mencari pertolongan medis terbukti menyelamatkan nyawanya.
Kisah ini kembali menegaskan satu hal penting: jangan pernah menunda saat muncul gejala serangan jantung.
Nyeri dada, rasa tertekan di dada, menjalar ke lengan atau rahang, sesak napas, atau keringat dingin—semuanya adalah tanda bahaya yang tidak boleh diabaikan. Semakin cepat tindakan dilakukan, semakin besar peluang untuk menyelamatkan otot jantung dan kualitas hidup pasien ke depannya.
Bagi kami sebagai dokter, momen melihat pasien pulih dan kembali ke keluarganya adalah kepuasan yang tidak bisa diukur dengan apapun.
Karena pada akhirnya, ini bukan hanya tentang prosedur atau teknologi. Ini tentang manusia, tentang keluarga, dan tentang kesempatan kedua dalam hidup.
My recent trip to ACC Asia 2026 in the historic city of Gyeongju was both professionally enriching and personally memorable. Known as “the museum without walls,” Gyeongju provided the perfect backdrop for a gathering of cardiology minds across the region.
A Proud Professional Milestone
One of the most significant highlights of this trip was being conferred the Fellow of the American College of Cardiology (FACC) during the convocation ceremony. Receiving this recognition from the American College of Cardiology is a meaningful milestone in my journey as a cardiologist. It represents not just years of clinical practice, but also a continued commitment to advancing cardiovascular care and improving patient outcomes.
Standing among respected peers and mentors, the moment was both humbling and motivating—a reminder of the responsibility we carry in shaping the future of cardiology.
Exploring the Timeless Beauty of Gyeongju
Beyond the conference halls, I had the opportunity to explore some of Korea’s most iconic historical landmarks:
The serene Bulguksa Temple, a UNESCO World Heritage site, offered a glimpse into Korea’s rich Buddhist heritage and architectural brilliance.
The ancient Cheomseongdae Observatory, one of the oldest surviving observatories in Asia, stood as a testament to early scientific advancement.
The Daereungwon Tomb Complex, with its rolling burial mounds, reflected the grandeur of the Silla dynasty.
Walking through these sites felt like stepping back in time—an inspiring contrast to the modern innovations discussed during the conference.
A Vibrant Stop in Busan
The journey continued to Busan, South Korea’s dynamic coastal city, where culture meets scenic beauty:
The colorful hillside houses of Gamcheon Culture Village created a lively and artistic atmosphere.
A ride on the Songdo Marine Cable Car offered breathtaking panoramic views of the coastline.
And of course, the iconic Haeundae Beach provided a perfect moment of relaxation by the sea.
Reflections
This trip was more than just a conference—it was a journey of growth, recognition, and cultural appreciation. From meaningful academic exchanges at ACC Asia 2026 to the honor of receiving FACC, and the unforgettable experiences across Gyeongju and Busan, every moment added depth to both my professional and personal journey.
Grateful for the experience, and looking forward to continuing this path of learning, service, and excellence in cardiology.
Grateful for the experience for Singapore Airlines Business class!!
On 21st April 2026, I had the privilege of speaking at the Sandoz JB GP Forum held at Novotel Johor Bahru City Centre. The event brought together general practitioners and healthcare professionals from across Johor for an evening of practical, case-based discussions aimed at improving primary care management.
My Session: Cholesterol Control in Real-World Practice
My talk, titled:
“Are You in Control of Your Cholesterol? Goals & Management of Hyperdyslipidemia”
focused on one of the most critical yet often underestimated cardiovascular risk factors — cholesterol.
We explored:
The importance of early detection and risk stratification
Updated LDL-C targets based on cardiovascular risk
Common gaps in achieving lipid goals in daily practice
Practical strategies to optimize treatment, including when to intensify therapy
The role of patient adherence and long-term follow-up
One key takeaway is simple but powerful: 👉 Many patients are treated, but not treated to target.
Bridging the Gap in Primary Care
Primary care plays a central role in preventing heart attacks and strokes. However, despite clear guidelines, a significant number of patients remain above their recommended LDL levels.
During the session, we discussed:
When lifestyle measures are not enough
When to escalate therapy beyond statins
How to individualize treatment without overcomplicating care
The goal is not just prescribing medication — but achieving outcomes.
Engaging Discussions & Collaboration
The session was followed by an interactive Q&A, where we had insightful discussions on real-world challenges faced by GPs — from patient compliance to medication accessibility.
It was encouraging to see such active participation and shared commitment toward improving cardiovascular care in the community.
Gratitude
I would like to thank Sandoz Malaysia for organizing this meaningful forum, and all the attendees for their engagement and thoughtful questions.
Final Thought
Cardiovascular disease remains the leading cause of death, but it is also one of the most preventable.
A CTO means that one of the heart arteries is completely blocked, often for several months or even years. Traditionally, patients with a totally blocked artery were often advised to undergo Coronary Artery Bypass Grafting (CABG) — commonly known as heart bypass surgery.
However, with modern advancements in cardiology, bypass surgery is no longer the only option for some patients. In many cases, CTO angioplasty (CTO PCI) may offer a less invasive treatment alternative.
Understanding the available options can help patients make more informed decisions about their heart health.
What is Chronic Total Occlusion (CTO)?
A Chronic Total Occlusion occurs when a coronary artery becomes completely blocked for more than 3 months.
This blockage is usually caused by the gradual build-up of:
Cholesterol plaque
Calcium deposits
Scar tissue within the artery
Because the blockage develops slowly, the body may sometimes create small natural bypass channels known as collateral vessels to supply blood to the heart muscle.
Despite this, many patients may still experience symptoms such as:
• Chest pain or chest tightness (angina) • Shortness of breath during physical activity • Reduced exercise tolerance • Fatigue with exertion
Some patients may also have silent CTO, meaning they have few symptoms but the heart muscle may still be under stress.
Traditional Treatment: Heart Bypass Surgery
For many years, the standard treatment for CTO was Coronary Artery Bypass Surgery (CABG).
During this surgery, doctors use a blood vessel from another part of the body to create a new pathway for blood to flow around the blocked artery.
Bypass surgery is a highly effective treatment and remains important for certain patients, especially when there are multiple blocked arteries or complex disease.
However, it is also a major surgical procedure that involves:
Opening the chest
General anaesthesia
Several days of hospital stay
Weeks of recovery time
For some patients, surgery may not be ideal due to age, medical conditions, or personal preference.
Modern Treatment Option: CTO Angioplasty (CTO PCI)
With advances in technology and expertise, cardiologists can now treat many CTO blockages using Percutaneous Coronary Intervention (PCI), commonly known as angioplasty and stenting.
During a CTO PCI procedure:
A small catheter is inserted through an artery in the wrist or groin
Specialised guidewires are used to carefully cross the blocked artery
Balloons are used to open the blockage
A coronary stent is placed to keep the artery open
Modern CTO procedures may involve advanced techniques such as:
• Dedicated CTO guidewires • Microcatheters • Retrograde approaches through collateral vessels • Intravascular imaging (IVUS or OCT)
In experienced centres, success rates can reach 85–90% or higher.
Benefits of CTO Angioplasty
For carefully selected patients, CTO PCI may provide several advantages:
✔ Relief of chest pain ✔ Improved exercise capacity ✔ Better quality of life ✔ Avoidance of open-heart surgery ✔ Shorter recovery time
Most patients are able to return home within 1–2 days after the procedure.
Example of my patient who has CTO LAD, there should be a vessel dictated by the red line. After opening the CTO, u can see coronary blood flow to the vessel.
Is CTO Angioplasty Suitable for Every Patient?
Not all CTOs require treatment, and not every blockage can be treated with angioplasty.
The best treatment approach depends on several factors:
• Severity of symptoms • Amount of heart muscle at risk • Complexity of the blockage • Overall patient health • Presence of other coronary artery disease
A discussion between cardiologists and cardiac surgeons — often called a Heart Team approach — helps determine the most appropriate treatment strategy.
A patient of mine with CTO LAD as shown with red dotted line, after opening the CTO, can see flow to the coronary vessel.
Important Message for Patients
If you have been diagnosed with a Chronic Total Occlusion, it is important to know:
It is not necessarily the end of the road for your heart artery.
While bypass surgery remains an excellent option for many patients, CTO angioplasty may offer a safe and effective alternative for selected individuals.
Patients are encouraged to discuss all possible treatment options with their cardiologist before making a decision.
Expert Heart Care in Johor Bahru
Patients with complex coronary artery disease, including CTO, should seek evaluation by an experienced cardiologist.
Dr Lim Wei Juan Consultant Cardiologist KPJ Johor Specialist Hospital
Dr Lim is experienced in the management of coronary artery disease, angioplasty and complex coronary interventions, including CTO cases.
Early consultation allows patients to explore the most appropriate treatment options tailored to their individual condition.
Expert heart care starts here ❤️ Welcome Dr Lim Wei Juan, Resident Consultant in Interventional Cardiology at Johor Specialist Hospital — delivering precision, safety, and advanced cardiac solutions. #CareForLife#HeartCare#JohorSpecialistHospital
As we welcome the Year of the Dragon, I would like to take this opportunity to wish everyone a very Happy Chinese New Year! 🧧✨
At KPJ Johor Specialist Hospital, we are grateful for the trust and support from our patients, families, and community throughout the past year. Chinese New Year is a time of reunion, gratitude, and new beginnings — a reminder to cherish our loved ones and, most importantly, our health.
As a cardiologist, I am constantly reminded that good health is the greatest blessing. This festive season, while enjoying the celebrations and delicious meals, do remember to practise moderation, stay active, and look after your heart. ❤️
May this new year bring you prosperity, happiness, and robust health. Gong Xi Fa Cai!
