People's ideas about causes of heart failure
The causes of heart failure are complex (see 'What causes heart failure' and 'Other causes of heart failure'). Those who have a family history of heart disease, those who smoke, are overweight or have diabetes are more likely to develop heart disease than those who do not. Many of the men and women we talked to were aware that diet and smoking were possible causes, but put forward many other theories including stress (see 'Stress and heart failure'), shift work, pollution, viruses, too much exercise, growing old, getting angry, and also bad luck. A doctor with heart failure said he found it unhelpful to dwell on the question “why”?
He finds it unhelpful to speculate about causes of heart failure.
I actually think its unhelpful to waste time wondering 'why', because no answer to the 'why' really helps with the question about 'what do we do next', and I think for myself it was more difficult to get my head round a prognosis, what the future would be for me, because... again you ask questions which people can't answer, and I suppose as a doctor I should know that my cardiologist couldn't tell me how long I was going live. But when you have a lot of things you want to do, get sorted out, it would be nice to have a much better idea of... the prognosis that you face.
There were mixed feelings about whether smoking should be blamed for people's heart failure, especially if people had smoked in the past, but stopped years before their heart failure started. Others, though smoking at the time of diagnosis, thought other things like stress and shift work were more important. Several said that some doctors blamed smoking for everything, and one man thought he was misdiagnosed with emphysema because he was a smoker. Others said that they had connected smoking with cancer rather than heart disease until they became ill.
How smoking and working shifts affected his heart.
No it was indoor work. Yes we worked, it was all machinery, we were manufacturing components for engines so it was all indoor work yes. Under artificial light I might add, no windows, and you know you didn't know night from day all the time. And we were, it was years ago, it was quite dusty as well, you know with the cast iron being machined and stuff like that. Later years they got extractors fitted and thing's like that, it was a lot better you know. But I think a lot of the stress and shift work and working upside down you know, that creates it.
So no smoking I don't smoke as well. I used to smoke years ago, oh I used to smoke. I don't know people keep saying how many did you smoke and I say well I can't remember, maybe it could be 20, 25... I don't know really I forgot. I packed smoking cigarettes up in '76, I did smoke a pipe after that and cigars you know so I don't know. And then I got, stopped the pipe a number of years ago and I packed up the, well I packed up the pipe when I had the triple heart by-pass to be quite fair and I never had any, I've had the odd one since but that's it you know. Well one or two maybe I don't know, I mean I can't be absolutely sure no. But I don't smoke now, I don't use them. Yeah.
Describes how smoking affected doctors trying to make a diagnosis.
Either, they couldn't decide whether, it was in the sac between, couldn't decide whether it was between my heart and my lung, and they couldn't decide what sac it was in. So it was a fairly unusual... diagnosis in so much that I was surrounded by young doctors etcetera who listened to it because although they'd read about it, nobody'd heard of it. To me it sounded like bubbling coffee every time I breathed, but to them it sounded like two bits of leather rubbing together. I was hearing a different sound to what they were hearing.
So I had 15 days in hospital with that, came out, went back to work...things seemed to be fine, got to Christmas of '91, and just after Christmas returned to college and was finding that I was extremely breathless. Any time on my feet caused me breathlessness, I had to climb stairs and it became a real hazard to me. I couldn't sleep at night at all, tried everything, tried different positions, ended up sleeping in this chair for several weeks and finally I slept at the dining room table sitting up. Couldn't get any sleep in any respect.
Wife eventually forced me to go to the doctor's. I went to one doctor who said to me I had to realise I did have a problem with my heart, not much you can do about it blah, blah, blah. Came home, spent another several days in distress, decided to go to another doctor in the practice who gave me much the same story as the first one had given me. Sent me home. All this time I was gradually getting worse. We decided to go to the third doctor in the practice who is supposed to be a specialist in heart. Went in, spoke to him, not congenial at all, not sympathetic. Asked if I smoked, I said, 'No, but I do like a cigar occasionally.' told me that was the problem, I had emphysema, I would just have to learn to live with it and gave me a nasal spray.
He gave up smoking after his heart attack.
High levels of cholesterol in the blood may mean that you have a greater chance of developing heart disease. Cholesterol levels may be reduced to some extent by eating less fat and exercising more regularly, and also by cholesterol-lowering drugs called statins. Many people knew that having a high cholesterol level in the blood was a risk and had taken steps to change their diet. Some found it difficult to give up fatty foods, for instance one man said that he had been in the habit of eating a lot of animal fat since his childhood, and another said that it was hard to avoid a high fat diet because of his cultural background. He also thought he should have been prescribed statins earlier on in his treatment. Another person said that knowing your cholesterol level could be unhelpful unless it could be changed, and that it might cause more worry than reassurance.
He reflects on his childhood eating and smoking habits.
What about smoking and drinking?
Oh I smoked from about 12, I started having little puffs about 12 and then let's see..'56, 1960, I was coughing up and that all day long and that all smoking about 30-odd fags a day!
His cultural background makes it difficult to alter his diet and lower his cholesterol levels.
When they told you, when they suggested that you lose weight and do more exercise did you try to do that?
Yes I did but I think it's, again it's to do with the culture and the background. I mean to say, if you, if you come from a different background the kind of food, or the type of food you're eating is totally different which is [long pause] which is affecting the cholesterol and the fat and weight, so that's... I try to but may be it was not enough.
Can you tell me what cultural background you're from and what you do eat?
Middle East, Middle East, and so most of the things is high cholesterol. It's like lamb and... the kind of rice, sweets, cakes and the oil we use, everything is oil, oil, oil, fat and butter and all this kind of thing. It's not like, it's not like the English diet where everything is healthy and vegetables, boiled. As I said even the vegetables are in the oil and fat. So the kind of foods is very very important of course.
Many people said they were told that their heart failure could be the result of a virus. One woman had been told that a virus may have caused her heart failure, but she wondered if she and her mother might have had the same pattern of illness. A raised risk of some types of heart disease can run in families; where this risk had been inherited people wondered if there was anything much they could do to combat it.
She thinks her heart failure may have been caused by a virus or her genetic inheritance.
What do you think?
I honestly don't know, I really don't know. The only thing I can say is my mother had the same thing when she was quite young, 9 years old actually, and that was after a 'flu - and I don't know the extent of the damage but she always took tablets for the rest of her life. After saying that, she led a normal life but I always remember her saying that she had a heart problem after having 'flu when she was 9 years old. So perhaps it's a weakness in our family. And perhaps it misses a few, I don't know, I don't know.
Last reviewed April 2016.
Last updated April 2016.