Tackling the challenge of fixing broken hearts

How could such a fit, young man, in the prime of his life, find himself so close to death in the middle of a major international spectacle being watched by millions?

Thankfully, in no small part due to the first-aiders who performed lifesaving resuscitation, the former Tottenham midfielder is now on the road to a full recovery, but the incident has brought home the very real threat that heart disease can pose to people of any age.

It has happened before, of course. Footballer Fabrice Muamba also collapsed on the pitch and cricketer James Taylor was forced to retire. Both, like Eriksen, have been fitted with a heart-starting device to ensure they survive any further episodes.

Eriksen suffered a cardiac arrest.His heart stopped and he effectively died before being brought back by medics. In many cases death can come from a heart attack, the symptoms of which can appear mild to start with.

The British Heart Foundation say the collapse of Eriksen has brought the issue of heart health back to the fore after months in which Covid has dominated the headlines.

“In the UK, it is estimated that at least 12 young people aged under 35 die every week from an undiagnosed heart condition,” says Chloe MacArthur, senior cardiac nurse at the BHF.

And she says while it can happen to anyone, regardless of sex, inherited heart conditions are often major factor.

Situation in the West Midlands, Staffordshire and Shropshire

When it comes to premature deaths from heart disease, the picture in the West Midlands looks rather gloomy. Figures from 2017-2019 show that Sandwell and Wolverhampton do particularly badly, with the third and fourth highest mortality rate per 100,000 people in England. In Sandwell, 469 people under the age of 75 died from heart-related conditions during the two-year period, a rate of 65.6 per 100,000, almost double the national average of 37.5, while Wolverhampton fared little better at 64.2 per 100,000.

Walsall also had a high mortality rate, with 60.9 people dying premature from heart disease per 100,000. Telford & Wrekin, at 45.6, and Dudley at 43.7, did better, but the number of premature deaths is still above the national average. Staffordshire, at 37.9, is fairly close to the national average, while the fatality rates for Shropshire and Worcestershire come below the national average, at 32.1 and 29.7 respectively.

Miss MacArthur says one of the leading causes of sudden cardiac death is hypertrophic cardiomyopathy (HCM), an inherited condition which affects an estimated one person in every 500. But while the condition might be commonplace, it also a hidden killer, as many people will display few, if any, symptoms.

“HCM means that the wall of your heart muscle has become thickened,” says Miss MacArthur.

“People who exercise a lot can also develop a thickening of their heart muscle, so tests will be needed to differentiate between a heart muscle that has become thickened through exercise and one that has become thickened because of a heart problem.”

New research funded by the BHF shows efforts to reduce the number of heart attacks and strokes are being stalled by weight gain and increasing prevalence of diabetes.

Clinical research fellow Dr Anoop Shah says while decreases in poor blood pressure, smoking and cholesterol levels contributed to a fall in the number of heart attacks and strokes between 1990 and 2014, progress has been hampered by obesity and diabetes over the same period.

Researchers from the London School of Hygiene & Tropical Medicine used Scottish health data to calculate the change in numbers of heart attacks and strokes in Scotland between 1990 and 2014.

They found that the number of heart attacks fell from 1,069 per 100,000 people to 276 per 100,000.

However, increases in average BMI and a doubling in the number of diabetes cases were estimated to be responsible for a 20 per cent increase in heart attacks and a 15 per cent increase in ischaemic strokes.

Risk calculator offers early warning

For many a heart attack literally comes as a shock. For others, the warning signs were there in terms of lifestyle and health.

Now help is at hand for medics who want to warn their patients about the risk of heart and circulatory diseases.

A so-called ‘risk calculator’ has been developed that can predict problems in an individual years before they strike.

The risk calculator, called Score2, enables doctors to predict who is at risk of having a heart attack or stroke in the next 10 years with greater accuracy. Researchers say the tool will help to save people act through lifestyle changes or medication like statins, ultimately saving lives.

Around 200 investigators and researchers across Europe analysed data from nearly 700,000 participants – mostly middle-aged – from 45 different studies.

When recruited to the studies, participants had no prior history of heart and circulatory disease, and in the 10 years they were followed up, 30,000 had a cardiovascular event, including fatal or non-fatal heart attack or stroke.

The risk tool used the data to more accurately estimate cardiovascular risk for populations split into four European risk regions. It uses known risk factors for heart and circulatory diseases such as age, sex, cholesterol levels and blood pressure. It also takes into account habits in young people, such as smoking, that can bring on heart problems in later life

The calculator accounts for current trends in heart and circulatory diseases, can predict both fatal and non-fatal conditions and is adaptable to countries with different levels of risk. Researchers say it can better estimate the cardiovascular risk amongst younger people, and will improve how treatment is tailored for older people and those in high-risk regions.

Professor Emanuele Di Angelantonio, of Cambridge University, said: “This risk tool is much more powerful and superior than what doctors have used for decades.

“It will fit seamlessly into current prevention programmes.”

UK survivors top 1.4 million – and there is plenty of support out there

If you have suffered a heart attack, you are not alone.

Approximately 1.4 million people in the UK today have survived a heart attack, while another 900,000 are living with heart failure.

The British Heart Foundation has been leading the fight against heart disease since it was formed 60 years ago.

Over that time the annual number of deaths from heart and circulatory diseases has fallen by about half.

But senior cardiac nurse at the Foundation Chloe MacArthur says there is still a long way to go.

“One in four people in the UK die from heart and circulatory diseases – and around 7.6 million people in this country live with them,” she says.

“That is why the BHF invests millions in life-saving research into heart and circulatory diseases each year to help realise our vision of a world free from heartbreak.”

Heart and circulatory diseases cause around a quarter of all deaths in the UK, accounting for more than 160,000 deaths each year.

That is an average of 450 deaths each day or one every three minutes in the UK.

Of the different conditions, coronary heart disease is the most common, and was the single biggest killer of both and men and women worldwide in 2019.

In the UK there are more than 100,000 hospital admissions each year due to heart attacks – one every five minutes.

As well as funding vital research which has led to vast strides in the way heart disease is treated, the British Heart Foundation also provides vast online and print resources for people living with heart conditions, with useful tools helping people to improve their diets and lifestyle to reduce the risk of heart disease.

In the West Midlands, a number of charities offer extensive support to aid with the rehabilitation of heart disease.

In Dudley, for example, Action Heart has built a free-to-use gym for patients at Russells Hall Hospital.

While in Shropshire, the Activate charity offers personal training and detailed rehab programmes.

Wolverhampton-based Have A Heart provides support for more than 500 patients, offering advice on how to stay fit after being discharged from hospital.

The British Heart Foundation has a register of local groups across our region.

Need help or advice?

• The British Heart Foundation is the best place to start.

• It can help directly or put you in touch with local groups.

• Call 0300 330 3311

• Visit bhf.org.uk