Heart failure spirals into major problem

Heart failure is a chronic, incurable condition that places a growing burden on hundreds of thousands of Canadians, the Heart and Stroke Foundation says in a new report.

In heart failure, the heart muscle is damaged or weakened. Survivors are left breathless and fatigued. Some may develop swelling in the ankles and feet or chest pain.

"The primary problem is the heart but then it affects all the other organs in the body, which then feeds back on the heart and can make it more difficult for the heart to pump," said Dr. Kim Connelly, a cardiologist and clinician scientist at St Michael's Hospital in Toronto. "It just sort of spirals back and forth. That's why it's such a major problem."

Of those who come to hospital with heart failure, one in four will be dead at one year, he said.

Leaving out childbirth, heart failure is the third most common reason for hospitalization, according to the Canadian Institute for Health Information, after respiratory disease and heart attack.

For some of the 600,000 Canadians living with heart failure, long and frequent hospital visits are needed. A huge part of the problem is trying to get rid of fluid to help the heart,Connelly said.

Drug treatments are effective to control heart failure, he said. There is no cure.

The primary problem is the heart but then it affects all the other organs in the body.-Dr. Kim Connelly

Vanessa Ring, 51, of Toronto was initially left with heart damage after bacterial meningitis at age 39.  Her heart was further weakened by H1N1 flu before the vaccine was available.

"You don't feel too perky when your heart function is reduced," Ring said.

Ring believes she's done remarkably well, and credits her attentive cardiologist, family doctor and supportive family.

"I can still work and manage my life but you are conscious of certain things. For instance, I'm not going to take on a 60-hour a week high stress job."

Ring said she often corrects people who believe she's had a heart attack.

"It's not a heart attack," Ring said. "It's an invisible disability."

Ring said initially, her top job was simply to heal. She supports the foundation's new report, released Tuesday, which she hopes will raise awareness of the signs and symptoms for people of all ages.

"We really want to support people so that they can have good quality of life. It helps everybody because it's less a burden on the system if we can get people back to being as functional as they possibly can be."

In Canada,Connelly said about two-thirds of heart failure is caused by coronary artery disease — the result of narrowing of the arteries from cholesterol build up. As treatments for heart attacks have advanced to keep people alive, some of those survivors will also go on to develop heart failure.

Other causes include inherited conditions and faulty heart valves.

Heart failure is managed with changes to lifestyle and medications. Devices such as artificial pumps may also help failing hearts.