'There were no outward signs that I was at risk of a heart attack'

It was three years ago when Damian, an IT specialist, from Blarney, opted to take a cardiac-screening test through his employer with Laya healthcare. He remembers sitting at his desk wondering if he could take the time to go and take up his slot.

Looking back, he says the decision to have the check may have saved his life. A number of routine tests were carried out. Damian recalls that he wasn’t worried. A non-smoker and busy father of three, he exercised when he could fit it in, playing basketball and doing a bit of running.

During his examination the doctor detected an irregularity in his heart beat which he felt warranted further investigation. Damian was referred to a cardiologist, who found, through a number of tests, that he had mitral leaking valve disease with blood leaking into the wrong parts of his heart.

The diagnosis was shocking. Damian says he hadn’t felt any pain in his chest although when he looks back he had been feeling tired and ended up more out of breath than usual when he exercised.

“There were no big outward signs. That’s the scary thing. It could’ve gone unnoticed. The worst thing that could happen is a heart attack because the heart is working that bit extra. I’m just lucky that I went in for the screening,” says Damian.

He had pioneering keyhole surgery in the Mater Hospital in Dublin to repair the valve – it didn’t need to be replaced – and was able to walk out of hospital. He describes his recovery as a slow enough process.

He engaged with a cardiac rehab programme where a team of experts on everything from diet to fitness and, as Damian describes it, to get his confidence back.

“I’d recommend that to anyone. There’s an education element reminding you about your diet and then there’s the exercise piece. I went to the gym twice a week for six weeks to build up my fitness as part of the programme,” he says.

Three years down the line Damian, now 45, says he’s trying to eat healthily and maintain his exercise in the midst of a busy working and family life.

“The kids – Sean (21), Avril (18) and Christian (8) got a fright. Sinead, my wife, was very much focused on how do we fix this? I’m more conscious of eating healthily now. I do a bit of sailing and I might go for a run. The early days of recovery were frustrating. For the first week I was only going for short walks but you build that up from 10 minutes and then 15 and gradually you’re going for a walk in the park,” he says.

According to Anne Gallagher, cardiac rehab co-ordinator at the Mater Hospital in Dublin, people attend cardiac rehab some weeks after their cardiac illness or treatment. They may have had a heart attack, stents, coronary artery bypass surgery, heart valve surgery, heart transplant, implantable cardioverter-defibrillator (ICD) surgery or a mild/moderate stroke.

The programme’s multi-disciplinary team provides a programme of exercise, information and support and includes access to a psychologist, a physiotherapist, a pharmacist and a dietitian.

“Our programmes are exercise-based but also aimed at preventing future episodes. The first thing we do is assess people using a treadmill exercise stress test. Patients then attend the programme twice a week over the course of eight weeks. On one of these days, they do an hour of supervised and ECG-monitored exercise. On the other day, they do an hour of exercise and have an hour’s education delivered by one of the team,” she says.

“The talks are on topics such as heart disease and its risk factors, healthy eating, managing stress, medications, the role of exercise in managing heart disease, an overview of cholesterol and blood pressure and managing angina. The psychological impact cannot be over-stated and access to a clinical psychologist as part of their care contributes significantly to overall clinical outcomes,” she says.

According to the hospital’s principal clinical psychologist, Dr Sinead Mulhern, a range of emotions including anxiety, shock, a sense of feeling overwhelmed, sadness, grief and anger are common, as well as a lack confidence and difficulties adjusting to the changes after a cardiac ‘event’.

She explains that around 33pc of people need further psychological support to cope with the anxiety that can arise.

“Often this is the first brush with mortality which can be a very shocking experience. As human beings we operate in a certain level of denial of our mortality in order to cope with our day-to-day life so that when this is challenged we can feel vulnerable. The most common emotional difficulties in the aftermath of a cardiac event include anxiety, low mood and a sense of being overwhelmed,” says Dr Mulhern.

The American Heart Association points out that as the burden of cardiovascular disease increases globally, cardiac rehabilitation (CR) is recognised as one of the most beneficial and cost-effective strategies to manage the disease and to reduce the risk of another event.

And the association says it’s shown to reduce mortality, hospital readmissions and costs as well as improving exercise capacity, quality of life and psychological well-being for people who have had a cardiac event.

At the Mater Hospital, Anne Gallagher says one thing that people on the programme always comment on is how it gives them their confidence back. “People can be really unsure about how much exercise they should be doing. I remember a man telling me how he had a stent in one day and then instant vulnerability. The team approach helps people understand all the elements they need to manage going forward,” she says.

The theme for this year’s World Heart Day, which falls on September 29, is to create a global community of heart heroes. The World Heart Federation is urging people to make a promise to their families to cook and eat more healthily, exercise more and stop smoking.

The federation points out that by making just a few small changes to our lives, we can reduce our risk, as well as improving our quality of life.

■ For more information see irishheart.ie and world-heart-federation.org

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