Heart Failure: Why You Should Know What It Is
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It’s one of the main reasons Canadians are hospitalized. It kills half of those diagnosed within five years – most within ten.
Yet not many of us even understand what heart failure is.
The Heart and Stroke Foundation’s 2016 Report on the Health of Canadians says we need to do more to support those with it.
Barb’s Story
Barb Kolomi is one of those living with heart failure.
In 2012, the 47-year-old was on a bike ride with her sons in Birds Hill Park.
“I just started experiencing chest pain. I really didn’t think much of it because when I got off my bike, the pain stopped. So I carried on throughout my day,” she said.
The next day, on another bike ride, the pain returned and spread down her arm. She started feeling ill. She just thought she was getting the flu. But things got worse.
“That evening, the pain was so bad I couldn’t even lie down, couldn’t go to sleep, so my husband rushed me to the hospital.”
Doctors told Kolomi she was having a heart attack, a rare form called spontaneous coronary artery dissection, where a tear forms in one of the blood vessels in the heart.
She survived, but her heart was badly damaged. She was suffering heart failure – her heart now only worked at 12 per cent capacity.
That is heart failure – when your heart muscle is damaged by something like heart disease or a heart attack, and can’t properly pump oxygen-filled blood through your body.
University of Manitoba researcher Ian Dixon says many people mistakenly believe it is a one-time event.
“If I talk to my family at Christmas time, half of the people in the room think that it means that the heart just shuts off. That’s not true at all. Heart failure is a slow, progressive, long event,” he said.
The Heart and Stroke Foundation says one-quarter of people believe heart failure means your heart stops beating completely.
Half believe heart failure can be cured. It can’t be.
More and more Canadians are living with heart failure – 600,000 Canadians right now. Dr. Dixon says it is partly because not as many people are dying from heart attacks.
“Now, those people are saved, they walk out of the hospital after about a week of care. They feel a little bit better and the heart can compensate for a while, but the grim reality is, five years down the line, half of those people wind up passing away or dying,” he says.
Heart disease can be managed through lifestyle changes like diet and exercise, and medication. But it is a chronic, long-term condition that gets worse over time and has no cure. Most people die within 10 years of diagnosis.
In the meantime, patients are often in and out of the hospital and juggling health care appointments. Heart disease the third most common reason for hospitalization in Canada, childbirth aside. The average stay is eight days.
Better Care Needed For Heart Failure Patients
Dr. Dixon says our health care system needs to do a better job supporting heart failure patients.
“Outpatient support for heart failure patients is almost non-existent. Instead what you have is patients running back and forth to the hospital over the last five years of their existence almost constantly. That costs a lot, it’s not very efficient, and it doesn’t help the patient very much because they get disorganized care for their problem,” he said.
The Heart and Stroke Foundation says many patients aren’t able to care for themselves completely and family and other caregivers have to step in.
Thirty per cent of heart failure patients also experience depression.
The direct cost of heart disease in Canada is high as well – an estimated $2.8 billion per year.
Better Research and Prevention Key
Dr. Dixon says we need to invest more in prevention and research to bring that cost down.
“Most of those dollars are spent trying to keep people alive after they develop it. Some of that money needs to go to prevention, and it also needs, most importantly, to go to basic research so that we can get that two-pronged leverage to beat this disease and make some inroads. Quite frankly, the field hasn’t moved very far in the last 20 years,” he said.
Research is being done to test whether after a heart attack, bad genes could be turned off and good genes that could help the heart could be turned on.
Dr. Dixon says good inroads are also being made in regenerative medicine, where the tissue that dies during a heart attack can be replaced with healthy tissue.
“There are ways to grow muscle cells that we can apply directly to parts of the heart that have lost all of those muscle cells and therefore reestablish a healthy heart rate,” he said.
Dixon says while those research areas are being developed, the best thing people can do is prevent heart disease and other conditions that lead to heart failure.
He says the advice isn’t new, but it’s effective – cut down on salt, improve your diet, stop smoking, moderate drinking and exercise.
Pump Keeps Kolomi Alive As She Hopes For Transplant
But sometimes, like in Kolomi’s case, genes take over. She didn’t smoke, ate well and exercised. Her doctors chalked her heart attack up to family history.
Kolomi has a device inside her that keeps her alive – a mechanical pump called a left ventricular assist device, which keeps her blood circulating throughout her body.
The pump is attached to a battery pack on the outside of her body, which she charges at night while she sleeps.
“Every once in a while, I have to plug myself in… So I’m on a short cord, so to speak. But during the day, I’m on batteries and that allows me great amounts of freedom,” she said.
She is also hoping for a heart transplant, but is one of 120 Canadians on the wait list.
In the meantime, her pump, and her boys, keep her going, just like after her heart attack.
“Those guys got me out of my hospital bed. My family really had me motivated to get out of there and come home, for sure,” she said.
“It’s such a cliché to say ‘don’t sweat the small stuff’, but I literally do live that. A lot of bad things happened in my life, but experiencing those bad things and accepting them helps me realize when I’ve got some good going on in my life to really appreciate them.”