It was a dramatic finding – 30 out of 300 shoppers – in Eyre Square, Galway who had a stethoscope check were referred to their GP for further tests. That’s one in 10 people who didn’t realise they had heart issues, but had simply availed of the free check by Croí, Ireland’s heart and stroke charity, when out shopping.
Heart valve disease (HVD), is the name given to any malfunction or abnormality of one or more of the heart’s four valves, affecting the flow of blood through the heart. Stethoscope tests can show up this disease that can cause breathlessness, fatigue and dizziness.
The problem is that Irish GPs don’t do these routine checks as regularly as GPs in other European countries, according to CROÍ’s CEO, Neil Johnson.
“This is despite the fact that stethoscope testing is recognised as the key detector of heart valve disease,” he says.
A European Heart Health survey has shown that only 32% of Irish patients over the age of 60 received a stethoscope check each time they visited their GP compared with 73% in France, for example.
HVD affects 13% of those over 75 with the risk increasing significantly after the age of 65. Because of Ireland’s ageing population HVD is also expected to be ‘the next cardiac epidemic’.
“We are calling, therefore, on all those over 65 to seek annual stethoscope checks – it could make all the difference to your long-term health,” Neil says.
St James’s consultant cardiothoracic surgeon and lecturer, Sarah Early agrees.
“The result of that stethoscope check in Galway highlights the importance of everyone paying attention to their heart health, even if they don’t have symptoms. It may turn out to be nothing but the check could save your life.”
Michael Burke, 71, from Tullaghmore, near Athenry, a semi-retired farmer and taxi driver, has reason to be thankful for getting his heart health checked out although getting lost in the healthcare system did delay his diagnosis, unfortunately. He tells Irish Country Living what happened and how he is doing now.
“Looking back, it began in the summer of 2014. The day after our second son’s wedding, the families went for a walk up a local hill and about a third of the way up I started to feel awful funny,” he says.
“My head was spinning and I was out of breath so I sat down and let the others go on. That was the beginning of it. I was aware that both my father and grandfather had died suddenly, each at the age of 70, so I made an appointment with my GP who booked me in for a stress test.
I got the call for that in December and during the test I could see the nurses looking at one another. As the treadmill speeded up I just jumped off, saying ‘I can’t do this anymore’. I was told something wasn’t right and that I needed an angiogram to find out more about my heart.”
That’s where Michael seems to have got lost in the appointments system.
“Nearly two years went by and I still didn’t have an appointment,” he says. “I did have the usual blood pressure checks during that time and took cholesterol tablets that I’d been on since my 40s but things came to a head in 2016 during lambing time. Every time I’d go out to the shed I’d go down on my knees coughing. It was a tremendous cough, like asthma, I thought maybe it was that the hay wasn’t great that year and that maybe I was getting ‘Farmer’s Lung’ but I’d be the same out in the fresh air when I’d go up the fields to see the other sheep. I’d go down on my knees most mornings coughing behind the wall as I wouldn’t want the neighbours to see me. I’d be on the point of vomiting with the cough, it was so bad.”
A story related to a death at a wedding catapulted Michael into going to the Emergency Department of University Hospital Galway soon afterwards.
“Our third son was getting married in 2016. We were in the hotel a few weeks before the wedding and we heard the story of a father of the groom dropping dead when he got up to make the speech. That got me thinking. The wedding was coming up in the middle of May so I thought I’d better get myself checked out.”
Michael drives taxis as an off farm income. Driving his taxi one Friday soon after, Michael found himself heading towards the hospital.
“I saw a taxi call coming up on the dash and I thought I’d get that but as it happened it didn’t come through so I wasn’t interrupted going to the hospital. My mother died the year before that. I think she must have been driving the car that day. I expected to get that call but it went off the screen so into the hospital I went.”
He had an angiogram a few days later and will always remember what the consultant said.
“He basically said that I wouldn’t see 70 if I didn’t have a quadruple by-pass operation. One of my arteries was 100% blocked, and the others were 45% blocked. I was in shock at first but then I wanted to get it done as fast as possible.”
The operation was done on 21 April 2016 and was a great success. Michael says he feels better now at the age of 71 than he did at the age of 61.
“Passengers have commented on the photo on my ID badge in the taxi. I look a lot different now. My face looks bloated in it.”
He spent just one week in hospital and found his legs healing after the removal of veins to be the sorest part of his recovery.
“That was the worst part but it went well overall. You have to be careful for a while afterwards so that you don’t burst your stitches but I was out of hospital on the seventh day and out walking the next day. Three weeks later my son got married and I was able to do the speech. I didn’t wait up for any festivities afterwards but I was able to do it.”
Michael’s advice to anyone reading this is to get your stethoscope check done and to follow up on any referral appointments that you get.
“Go to the hospital yourself if you’re worried,” he says. “When you hear the word ‘heart’ you get a fright at first but there’s a lot can be done now with operations.”
He believes that many farmers don’t look after themselves well enough. “They wouldn’t think twice about ringing a vet in the middle of the night, it wouldn’t matter what it’d cost but if it’s yourself you say ‘I’ll be all right, I’m not going down there giving €100 to the doctor’. I’m monitored now every six months. Have your check-ups and make sure there is follow up.”
What is HVD?
Heart valve disease is when one or more of the valves in your heart become diseased or damaged, preventing them from opening or closing properly.
You have four valves in your heart (two on the right, two on the left) that keep blood flowing in the right direction. The two most common heart valves that develop problems are the aortic valve (between the left lower chamber and the aorta) and the mitral valve (between the left upper and lower chambers).
These valves can be affected in two ways:
• the valve area can become narrowed, not opening fully and causing an obstruction or blockage to the flow of blood. This is called valve stenosis; or
• the valve may not close properly allowing blood to flow backwards in the wrong direction. This is called valve regurgitation or incompetence.
What are the causes?
• Congenital heart birth defects, infections and degeneration over time. Due to wear and tear or high blood pressure, the prevalence increases with ageing.
• You may not experience any symptoms of heart valve disease for many years or they may seem vague and non-specific.
• Symptoms can include: shortness of breath particularly on exertion; fatigue or feeling excessively tired; swelling of the ankles; chest pain or tightness.
• Sometimes valve disease is only discovered when your doctor listens to your heart with a stethoscope and hears an abnormal heart murmur (heart sound).
CROÍ can be contacted at 091-544310 or email firstname.lastname@example.org. See croi.ie and Irish Heart Foundation at irishheart.ie.