Ask a Cardiothoracic Surgeon: Dr Lim Yeong Phang from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: CardiologyAsk a Cardiothoracic Surgeon: Dr Lim Yeong Phang from Mount Elizabeth Novena Hospital Singapore
dr. Lim Yeong Phang asked 2 years ago
I am Dr Lim Yeong Phang, Cardiothoracic Surgeon based in Mount Elizabeth Novena Hospital. Ask Me Anything! I have a keen interest in Minimally Invasive Cardiac Surgery and introduced the Endo Radial harvesting procedure using harmonic scalpel technology at the National Heart Centre, Singapore. I also trained the junior staff in Endo Vein harvest procedures. I perform Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) via the chest wall without cutting through any bone. I also perform Hybrid Coronary Revascularisation (a combination of surgical bypass and percutaneous stenting) with Interventional Cardiologists. I am a member of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS). I studied medicine at Trinity Hall, University of Cambridge, United Kingdom. I completed my BA(Hons) in Medical Sciences Tripos in 1989 and graduated with MB BChir(Camb) in 1992. I did my housemanship at Addenbrooke's Hospital in Cambridge and Peterborough District Hospital, United Kingdom. Upon my return to Singapore, I served as a Medical Officer in the Republic of Singapore Air Force. I underwent the Aviation Medical Officer's course and was the Medical Officer in charge of Sembawang Airbase Medical Centre during my active national service tenure. I chose to train in Surgery and in 1998, successfully obtained both the FRCS(Edinburgh) and FRCS(Glasgow) diplomas. I joined the Department of Cardiothoracic Surgery, Singapore General Hospital in 1998. I was awarded the Higher Manpower Development Plan (HMDP) fellowship in 2005 to the Cleveland Clinic, Ohio, USA, which has been ranked in the USA as the number one in heart care since 1995. I trained in congenital heart surgery under the world renowned Dr Roger B.B. Mee. When I returned to Singapore in 2006, I was appointed Consultant at the National Heart Centre (NHC) and subsequently Senior Consultant. I was also appointed Visiting Consultant to KK Women and Children's Hospital. I spent 3 months in Wuhan Asia Heart Hospital, Wuhan, China as a recipient of the Singhealth Talent Development Scheme in 2007. In 2000, I was a member of the surgical team that performed Singapore's first Lung Transplant. I was also part of the surgical team that carried out Singapore's first combined Heart and Liver Transplant in 2011. I was appointed Director, Cardiac Operating Theatre, NHC in 2012. Through a grant from the Ministry of Health, Singapore, I established the National Cardiovascular Homograft Bank in 2008 at the National Heart Centre(NHC) with my colleagues and serves as its Medical Director. In 2011, the National Cardiovascular Homograft Bank became the first Tissue Bank outside North America to obtain the American Association of Tissue Bank (AATB) accreditation. I am a member of the AATB. I am one of only 2 doctors in Singapore who holds the Certified Tissue Banking Specialists (CTBS) Diploma from AATB. I promoted the use of Extra Corporeal Membrane Oxygenation (ECMO) in Singapore and was co-director of the ECMO programme at NHC. I organised an ECMO Symposium as a part of the 17th SGH Annual Scientific Meeting. I also organised training for intensivists, respiratory physicians and cardiologists during the H5N1 pandemic in 2009. I have served as an Adjunct Assistant Professor on the teaching faculty of Duke - NUS Graduate Medical School and lecture at Nanyang Polytechnic for the Advanced Diploma Nursing Course. I served as Chairman of the NHC Healthy Lifestyle Committee. I am a member of the Association of Thoracic and Cardiovascular Surgeons of Asia, Singapore Cardiac Society and Chapter of Cardiothoracic Surgeons, Academy of Medicine, Singapore, European Association of Cardiothoracic Surgeons, Society of Thoracic Surgeons. I received the Gold Service Quality Award from NHC in 2010. Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/lim-yeong-phang/ I am excited to be here to share/discuss Cardiac Health with everyone. I will be actively answering questions. Whether you've got questions about cardiac surgery such as bypass surgery, stenting, heart valve disorders, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
19 Answers
Zaenal Mursidi answered 2 years ago
Doctor, my chest hurts at night and my breath is short. This happens every other day. I used to have tuberculosis, but I had it treated. Is there any chance my current condition is related to my tuberculosis?
dr. Lim Yeong Phang replied 2 years ago

If the symptoms of chest pain or breathlessness after TB treatment is new , you should see a dr to investigate as there maybe something new happening after TB infection. TB can be effectively treated but if a patient was a smoker or had TB for some time already, some damage to lungs may have occurred . Also some patients after TB infections are especially susceptible to certain types of infections like fungal infections and also in some cases can have lung tumours. For the above reasons, if you have the type of symptoms , you should see a chest physician or surgeon and do some tests including a CT scan of your chest to find out if there are any are disease processes occurring.

Yoga Abshar answered 2 years ago
Doctor, I have pain in my lower left chest, it gives me a cramp on my left arm. I often feel weak due to this condition. But it will get better by itself. I don’t have any other symptoms. Is this dangerous?
dr. Lim Yeong Phang replied 2 years ago

It is difficult to advise you without any knowledge of your age or relevant medical history or any other details of your complaint. There are many causes of left chest pain going to left arm ranging from chest wall conditions, spine conditions to heart conditions. perhaps it would be better to see a general practitioner to see if there are any serious concerns.

Ziazia answered 2 years ago
I often stay up late, and lately I feel chest pain even though it's not every day but it makes me worried. Does this mean there is a problem with my heart because I often stay up late?
dr. Lim Yeong Phang replied 2 years ago

There are many people who stay up late at night but do not experience chest pain. I do not think it is a direct cause of your chest pain but perhaps more often its is perhaps the lack of sleep or long working hours that causes stress that can lead to all types of symptoms including chest pain. If your chest pain occurs very frequently or is getting worse or is related to exertion then you should seek medical attention to evaluate the possible causes.

Rahmat Hartono answered 2 years ago
I’m a smoker, male, 35 years old. I have a lot of friends that are also smokers that have heart attacks and had bypass surgery. Is it correct to say that smoking is the main cause of heart attacks?
dr. Lim Yeong Phang replied 2 years ago

Smoking is a risk factors for many diseases including heart attacks, strokes, vascular problems and also linked to a large number of cancers and lung conditions. It can accelerate the progression of arterial disease including coronary artery disease leading to heart attacks. There are many causes of heart attacks in the young including diabetes, vasculitis , familial hyperlipdeamia( genetic condition with very high cholesterol levels) .It is possible that heavy smoking can bring forward the onset of coronary artery disease. Therefore if you are still smoking at 35 , I would advise you to stop it and there will benefits even eat your age including risk reduction from cancers and arterial disease.

R. Yeow answered 2 years ago

I had an ECG to check on my heart palpitation issue at the beginning of 2020. The result was fine, everything was normal. However, this week I am feeling palpitations again with pain in my right chest. I often wake up in the middle of the night to catch my breath. Should I follow up with another check up? I read some articles that it can be due to stress.

dr. Lim Yeong Phang replied 2 years ago

You can get a continuous ECG monitor( called a holter study). It will record your ECG over 24 h and analyse as your palpitations were not captured on the ECG performed. The other option is to wear a event recorder which is like a watch and press the record button when you feel the symptoms ( A version of this is the Apple watch). The event recorder can be worn for few days or a week .

This will help record the ECG and help make a diagnosis.

Lionel answered 2 years ago

My right chest is swollen and red. I also feel a hot sensation in my chest and it moves up to my throat. This only gets better when I cough phlegm out. Should I be concerned about this?

dr. Lim Yeong Phang replied 2 years ago

It sounds like you are having some sort of infection. You should see a physician to get evaluated. It is possible that you are having a chest infection .

Yan Kiat answered 2 years ago

I always feel there is phlegm that cannot be coughed out inside my chest. I will inhale steam from hot water. This will make my nose runny and I can try to cough out the phlegm slightly. However, after a few hours, the feeling of phlegm being stuck in my chest comes back. What should I do? I am 41 and a smoker

dr. Lim Yeong Phang replied 2 years ago

Chronic smoking can give rise to chronic smokers cough and can result in lung damage and is a well known risk factor for lung cancer. I would encourage you to stop smoking. You may experience a transient increase of phlegm in the short term but if you persist it will improve.

Mrs Fang answered 2 years ago

My 15 year old son has difficulty breathing at night. He often wakes up in the middle of his sleep and his breath is loud, like as though he has asthma. In the day he looks fine, except he always looks like he does not have enough sleep. Is this something dangerous?

Gina Tay answered 2 years ago

My daughter was diagnosed with tuberculosis in 2019. Back then she was put on a course of medications. However, lately she has been suffering from palpitations and constant perspiring especially during the night. She said her chest feels painful. In the mornings, she is weak and this affects her mood. That said, her cough is not as severe as it was before. What should I do? Could it be that the tuberculosis was not fully treated?

dr. Lim Yeong Phang replied 2 years ago

TB is an infection which can be treated effectively nowadays however it can cause some damage to lung tissues and result in long standing symptoms. The treatment of TB is over a few months. If she is having new symptoms or not feeling better despite adequate treatment, she should see her chest physician or infectious disease doctor to get an evaluation . She may need to do some blood tests and a lung scan.

James answered 2 years ago

I want to ask - at what point would stents no longer be considered and a bypass surgery be mandatory?

dr. Lim Yeong Phang replied 1 year ago

Stents are essentially synthetic constructs impregnated with small doses of chemotherapy drugs to prevent scarring. Bypass surgery uses a person’s native blood vessels as bypass conduits. Stenting and bypass strategies are also different. Stents may not be considered if a person’s stents kept failing or failed in a short space of time as sometimes an individual ‘s reaction to foreign body implants may vary. In certain anatomical locations stenting may be of higher risk to patient then bypass surgery. A cardiologist or cardiac surgeon can advise on the appropriate treatment modality and associated risks and benefits.

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