Finding that you can’t walk too far without feeling breathless? That your ankles are swollen? Or that you are feeling very tired?

Dr Angie Brown, consultant cardiologist and medical director of the Irish Heart Foundation says that these could be the signs of heart failure and shouldn’t be ignored.

“If you have heart failure and have it diagnosed early you can start treatment early. That can prevent it getting worse or even make it get better.”

The term “heart failure” is used to describe a heart that is not working as well as it should.

While this can sound quite frightening, it is important to understand that your heart is not about to stop, Dr Brown says.

“It can certainly cause a build-up of fluid in the lungs (lung congestion) causing breathlessness or leg swelling, but these symptoms can improve with suitable treatment allowing you to live well with heart failure,” she says.

Treating underlying causes

She gives examples of what can be done to resolve underlying issues.

“If a valve problem is the underlying cause, you can have that treated with a valve replacement. If you have high blood pressure that can be treated as well. If it’s due to narrowing in the arteries they can be stented and that can sometimes improve heart function.

Treatment can improve people’s quality of life and mobility.

“Heart-failure related medication now is excellent also and pacemakers can have a beneficial role in some cases. Treatment can improve people’s quality of life and mobility. It means people can live longer and have a better quality of life so it’s really important to get diagnosed and treated early. That’s why we’re calling for people to become aware of the signs and symptoms.”

She recommends using the Irish Heart Foundation’s special symptom tracker website – www.knowyourheart.ie

“You can fill in the interactive tool, print it out and take it along to your GP as a useful starting point. He/she may say, ‘We’ll do a few checks’ and you might be referred to hospital for an echocardiogram or some other tests if necessary.”

Varies in degree

She points out that there is a wide spectrum in relation to heart failure.

“In some cases it can be reversed or treated and people with it can live very long and active lives, but in the more severe forms of heart failure the prognosis can be poor. It’s like cancer – if you’ve got very poor heart function, then there is a much higher risk of dying suddenly. In some cases patients may need a special form of pacemaker an internal cardiac defibrillator (ICD).”

The message we’d like readers to take home is to be aware of the signs and symptoms of heart failure

Yes, heart failure may be a frightening condition, but if caught early, treatment can be successful.

“You can’t avail of that treatment, though, unless you’ve been diagnosed,” she says.

“The message we’d like readers to take home is to be aware of the signs and symptoms of heart failure.

"Don’t be scared of it because it is much better to know why you are getting breathless, why you are getting these symptoms so that they can be treated.

"For a lot of people that works out well and they can live a good-quality, long life.”

What happens to your heart

Heart failure occurs when the heart is too stiff or weakened. That means it doesn’t fill properly or doesn’t contract properly.

“The heart is then weak and the blood doesn’t circulate round the body properly,” adds Dr Brown.

“That can lead to oxygen not getting to the organs and the build-up of fluid in the lungs and in the feet. That can obviously make you feel breathless, it can cause swelling of your ankles and can make you feel very fatigued because not enough oxygen is getting to the muscles.”

Heart failure can come on gradually and breathlessness can be caused by other things so that’s why people tend to put going to the doctor on the long finger

People with heart failure may also find they wake up at night breathless or may cough and have a wheeze or have palpitations.

Why, then, do people not go to the doctor and be diagnosed early with heart failure?

“Heart failure can come on gradually and breathlessness can be caused by other things so that’s why people tend to put going to the doctor on the long finger. They say, ‘I’m not fit, I’ve put on a bit of weight, I haven’t been doing any exercise, I have got a lot of stress at work…’

“There are lots of reasons why a person could be getting breathless so they may ignore the symptoms because nobody really wants to think they have heart failure but being aware of it is very important.”

On the increase in Ireland

Heart failure is on the increase in Ireland, she states. “It’s increasing exponentially because people are living longer. This increase in the number of people with heart failure will lead to an increase in hospitalisations from heart failure of more than 50% over the next 25 years so awareness about early diagnosis is important.”

People are living longer for a number of reasons, she points out.

“It’s partly because we’re better at treating heart disease, at stenting people, at doing bypass grafting.

Obviously the risk factors are more common as you get older but you can get heart failure at any age

"We also have better treatment for those with congenital or inherited heart disease – potentially other causes of heart failure.”

High blood pressure, obesity and sedentary lifestyles can also be factors.

“Valve problems, excess alcohol, smoking, being physically inactive – they all increase your risk of heart failure,” she says.

Heart failure can also happen at any age.

“Obviously the risk factors are more common as you get older but you can get heart failure at any age. Children can be born with holes in the heart or with abnormal hearts,” she says.

“People can get viral infections of the heart at any stage also. Obviously, if it’s genetic, it can occur at any age also but for the most part heart failure can occur when you’re older because as you get older the risk goes up.”

Information

Heart conference

Venue: Croke Park

Date: Monday 2 December

Time: 10am-4pm.

Free event but please register. For people with a wide variety of heart conditions. To register see www.irishheart.ie. Registration through Eventbrite.

Helpline

Speak to the National Heart & Stroke Helpline Nurse. Need to talk? Freephone 1800 25 25 50 Monday-Friday 9am-5pm.

Article

You can read Sunday Game presenter Michael Lyster’s story of living with heart failure here

Iron deficiency and heart failure link

Croí is a regional heart and stroke foundation working in the west of Ireland. Its aim is to “prevent disease, save lives, promote recovery and wellbeing”.

Its subsidiary, the National Institute for Prevention and Cardiovascular Health* concentrates on preventive healthcare and has recently flagged the link between iron deficiency and heart failure.

“There is an increasing awareness of iron deficiency,” says Neil Johnson, CEO of Croí. “The research literature seems to suggest that it was frequently overlooked and that the prevalence of iron deficiency in heart failure could be anything from 30-50%.”

Being deficient in iron can contribute to cardiac muscle dysfunction, he states. “In general, there are poorer clinical outcomes and a greater risk of death in people who have heart failure and who are deficient in iron. It’s really a co-morbidity of heart failure (an additional condition existing along with the primary one),” he says.

He highlights an interesting fact around this. “Interestingly, heart patients for whom it has been discovered that they are iron deficient and for whom that is remedied, report feeling better. This is an important variable in heart failure because heart failure is a chronic condition and for those living with it, quality of life in particular is probably their biggest priority. So anything that makes you feel better is a bonus. If a heart failure patient is feeling tired and then it’s discovered it is an iron deficiency they say, ‘I feel more energetic’. The key thing is that it is a co-morbidity of heart failure so it’s something that should be checked for,” he says.

Recent international guidelines have highlighted the need for monitoring iron levels among heart failure patients, he says. “We are highlighting this issue because of those guidelines. Typically heart failure patients are older and heart failure can be a complex condition, so we are taking the opportunity to highlight the complexity and the link with iron deficiency.

If iron levels are correct it has a favourable effect on exercise as well. This helps heart failure patients can stay as active and mobile as possible.” World Iron Deficiency Day is 24 November 2019.

*The National Institute for Prevention and Cardiovascular Health is concerned with raising the standards of preventive healthcare in Ireland by engaging in research and professional healthcare education. Croí is completely funded by the proceeds of fundraising events, voluntary contributions and philanthropy.

Free health checks

The Irish Farmers Journal has committed to offer free health checks to farmers. Croí cardiovascular nurse specialists will deliver the following services to attendees at our upcoming mart demos:

  • Blood pressure measurements.
  • Pulse checks.
  • A personal record card and educational materials.
  • Referral to GP or suggested follow-up support with identified high-risk individuals where necessary.