Cardiac rehab - giving heart patients their lives back

So, thanks to NICE publishing an updated guide on the management of chronic heart failure, we now know even more about the benefits of cardiac rehabilitation.

But so what? Why is cardiac rehabilitation so important to the thousands of heart patients out there?

Well the simple answer is it saves lives.

At the moment only 38 per cent of heart patients enjoy the benefits of cardiac rehabilitation - that figure should, and could, be much higher.

The term rehabilitation can actually be a bit misleading. Basically, it is a tailored program of information, education, exercise, lifestyle advice and help with medication.

Crucially it’s also advice and help with the worry, and sometimes depression, associated with this serious disease. In short, it puts you back in control of your life.

It could cost the earth but is doesn’t. Cardiac rehab can cost as little as £600 per patient. Not a lot when it comes to changing - or even saving - someone’s life.

After all, we already know the number of people who die from heart problems after their cardiac treatment is reduced by a quarter following rehabilitation.

It’s an incredible service and yet it is still available to so few.

The prize is improving people’s lives and using NHS resources better by reducing the burden on expensive hospital admissions.

This is a problem that we can fix. For the sake of heart patients and their families, the NHS needs to drive up the numbers benefitting from cardiac rehabilitation.

You can find out where your nearest cardiac rehabilitation programme is by visiting www.cardiac-rehabilitation.net or calling the BHF Heart HelpLine on 0300 330 3311.

By Dr Mike Knapton

New smoking figures - bitter sweet news

Today’s figures on the number of people smoking – and quitting – are bittersweet.

The latest NHS statistics show that while more people are kicking the habit, the percentage of smokers in England has remained the same. While it is great news that more people are successfully quitting, it sadly looks as though the tobacco industry is still able to recruit legions of new smokers to replace those who quit - or die from smoking related ill health.

We know the tobacco industry is trying harder than ever to find new recruits, which is why those firms are so opposed to new laws banning cigarette vending machines and tobacco displays in shops.

It’s a fact that two thirds of smokers start before they are 18, and we know tens of thousands of teenagers regularly get hold of cigarettes from vending machines because they are an easy source of tobacco where people rarely check for age identification.

We campaigned hard for this new law because banning vending machines would cut off this easy access to cigarettes by young people and getting rid of tobacco displays would close off one of the few remaining ways for tobacco firms to market their products to such an influential audience.

Everyone, even the tobacco firms, know that smoking is bad for you and the scientific case against it is long and well established. It’s a major risk factor for developing heart disease borne out by the depressing figure that 25,000 smokers die every year from smoking related heart disease. A total of 114,000 smokers die more generally as a result of their habit.

Yet tobacco firms are hard at work lobbying the Coalition government in the hope ministers will back down. We think we should be doing everything we can to protect children from smoking. You can help by writing to your MP asking them to make sure this law becomes reality. The health of our young people depends on it.

By Joseph Clift

Policy Officer

Live chat nurse Judy - the final question

Katie asks: “Hi, I am 27 years old and was born with my left coronary artery on the wrong side. I had this re-implanted at 10months old and also suffered a heart attack. I have since found out in October last year that my valves were leaking and they were going to replace them up until I had an angiogram in January and they discovered my heart was enlarged. Plus almost 1 1/3 of my heart is just scar tissue from having the heart attack as a baby. So I was told the only option for me was a heart transplant. So I now take 3 different meds a day and I am becoming more symptomatic showing breathless, limited exercise tolerance and chest pain. I have been referred to another consultant for a transplant assessment and wondered what this entails exactly? I am a mother of 3 and a wife, as you can imagine this is a very anxious time for us all. How long is recovery after transplant? How long will I be in hospital for? Look forward to hearing from you.”

Judy says:

I am so sorry to read of your very complicated medical history and of your need to have a heart transplant so young. I totally appreciate how hard it must be for you, your husband and your young family. The recovery period following a heart transplant varies considerably from one patient to another. You can read more about what to expect before and after the surgery in our BHF publication on heart transplants. I hope that you will be ok, that you will be accepted for the surgery and that you will be given a new heart soon. If you want to chat about this you might find it easier to call our HelpLine on 0300 300 3311 and talk to a cardiac nurse. I wish you good luck with everything and I hope that you have the support you need and deserve from family and friends.

You may also want to contact the heart transplant support network on 0800 027 4490 or the their website.

Live chat with nurse Judy

Frances asks: “My 16 year old son had open heart surgery last month to replace aortic valve. As a result of heart block, he has now had a pacemaker fitted. Once everything is healed, and he is fully recovered, what is the maximum weight he can safely lift? The reason for asking is that he is looking at career choices and wouldn’t want to choose something physical if it could affect his health.”

Judy says:

I hope your son is making a good recovery from his open heart surgery and his pacemaker insertion. It’s hard to give you a definitive answer to your question as I don’t know his full medical background and the type of heart condition he has. If he has congenital heart disease, he should have a chat with his cardiologist about career choices. Some young people with complex congenital heart disease are encouraged not to do weight lifting but others with more simple congenital heart disease do not need to be so careful. I hope that your son’s cardiologist will be supportive and give you him the advice that he needs. I wish him luck with his health and his career choice.

Live chat with nurse Judy

Denise asks: "Hi Judy I’m 42 awaiting valve surgery they have said I’ve got a tiny femoral artery it needs some electrical rewiring and there’s a hole. I’m just a bit worried about being on warfarin all my life they have said if it cant be repaired a metal valve will be fitted any info about the warfarin I’d be grateful thanks."

Judy says:

I am sorry to read that you need to have valve surgery and I understand your concern about taking warfarin for life. There are benefits and risks associated with taking warfain which you can read about here. If you have a metal valve replacement you will have to take warfarin for life as otherwise a potentially fatal clot would build up on the valve. When making the decision about surgery what you need to consider is what are the risks associated with the surgery (and with warfarin) versus the risks associated with not having the surgery in the first place.

It might be worth talking to your surgeon about this again if he or she did not explain the risks of not having surgery. You can read more about valve disease here. Whatever you decide I wish you good luck with it and good health for the future.

Live chat with nurse Judy

Eric asks: I had a minor heart attack in 2002 and have been put on ramipril, simvastatin, metoprolol tartrate and asprin for life. What evidence is there to prove that I will live any longer taking the pills. Being a scientist by training I like to evaluate evidence for myself and not do something because some government dept. thinks its a good idea! I run, go to a gym twice a week and have not had a problems since 2002. Have I improved my chances of avoiding HA or are the chances still the same as if I had put my feet up?

Judy says:

I am sorry to read that you have experienced a heart attack but it’s great that you have made a good recovery. It’s difficult to point you in the direction of the evidence which supports the use of the cocktail of medication used to prevent a second heart attack as this evidence is not in one place. As a scientist yourself I am sure you will appreciate that the vast body of evidence has been accumulated over many years from scientists and medical researchers across the world. If you have a look at the stats on our website you will see that the death rate from heart disease has been steadily declining and the medication prescribed post a heart attack will have contributed to this decline. Other contributing factors include more prompt diagnosis and better access to emergency treatment (clot busting drug) at the time of the heart attack.

But you are right when you point out that medication alone is not enough and a healthy lifestyle is a vital part of the post heart attack rehabilitation. Its great that you have taken control over your health by going to gym twice a week.

I hope that this has answered your questions and I wish you good health in the future.

Live chat with nurse Judy

Janie asks: “How does a Bivent work I understand the pacing and defib, but unsure about the other function, I have one fitted due to Cardiomyopathy”

Judy says:

The benefit of biventricular pacing is that it in addition to regulating the heart rate, it can help to improve the pumping function of the heart muscle. There are three leads, one in the atrium, one in right ventricle and one in the left ventricle. By pacing both ventricles it help to synchronise them and thereby helping to make the heart more efficient. This can help to relieve symptoms. You can read more about biventricular pacing in our booklet pacemakers and more about cardiomyopathy here.

Live chat with nurse Judy

Sharon asks: “Hi Judy, my husband is awaiting triple bypass surgery, and we're quite anxious about it. How long will he be in hospital and what is the approximate recovery period. We haven’t really had a chance to discuss it with anyone yet. He is 43 years old and otherwise in good health. Is there any site you'd recommend for us to read up on the procedure?”

Judy says:

I can understand your anxiety – the waiting time before surgery is often the very worst part. We have a booklet called "Having heart surgery" which explains what is involved just before, during and after bypass surgery. You can download this booklet from the BHF website here.

The average time in hospital following bypass surgery is 5 to 7 days but it varies from one patient to another depending on whether or not there are any complications such as infection or disturbance to the heart rhythm. It’s very important to attend a cardiac rehabilitation programme and partners are encouraged to attend as well as it can be a difficult time for you as well. You can read more about the benefits of cardiac rehab here.

I wish your husband the best of luck with his surgery and please feel welcome to contact us again if you have any more questions

Live chat with nurse Judy

Carey asks: “Hi Judy, I'm 31 and had a heart attack end of March this year. I was put on 1.25mg Ramipril once a day (amongst other things!), which last week was increased to 2.5mg. On the lower dose I felt fine, but since the dose being increased my heart misses a beat quite frequently; approx. 5 times an hour. Is this something to... be concerned about and should i go to see my GP to go back on the original dose? Thanks Carey”

Judy says:

I am very sorry to read that you have had a heart attack at such a young age. Ramipril belongs to a group of drugs called Ace Inhibitors. Those drugs can drop your blood pressure quite quickly when you first start taking them. So it is standard practice to start on a low dose and gradually increase. 1.25 mgs is usually considered to be too low for long term use so it is not surprising that your GP increased it to 2.5 mgs.

Your symptom of being aware of your heart beat or feeling that your heart misses a beat every now and then is not uncommon. It may be that you have a disturbance to the heart rhythm or it may be that you are just experiencing an extra beat every now and then which is harmless. It would be worth reporting it to your GP who could arrange for some tests to help you get to the bottom of it. Hope this helps. I wish you good health for the future.

Live chat with nurse Judy

Luke asks: “I recently had my cholesterol checked and it was high. 7.9 to be exact, but the HDL was high at 1.3. I am 33 years old, my mother and grand mother both have high cholesterol and take tablets. No family history of heart attacks before 50. I am fit and well, and very active. Gym 2-3 times per week, football twice a week. I changed my diet as I ate a lot of eggs, and now only have eggs once a week. I take benecol and use flora pro active butter. I have cut down on my saturated fat intake, and I eat more porridge, lentils, pulses, fish etc. I always have 5 a day in fruit and veg. I drink alcohol at weekends and probably consume between 20-30 units. I smoke 1-2 cigars at the weekend. I was surprised by my reading, as I am not over weight, and I have a good diet or so I thought. I have lowered it to 5.9 now, but I still need to lower it further. Is there anything more I can do?”
Judy says:

It’s great that you are doing lots of exercise each week and eating healthily, so it’s a shame that your smoking and drinking habits are so unhealthy. 20 to 30 units of alcohol over 2 to 3 days is excessive and way beyond the recommended guidelines of 2-3 units a day for men. Alcohol is very high in calories and binge drinking is potentially damaging to the liver and the heart. Smoking is also a significant risk factor for developing heart disease in the future. It sounds as though it’s the weekends that you struggle with – it might be worth trying to identify small steps you could take to change your weekend habits. Only you will know which steps are realistic and achievable but I recommend that you identify some tangible goals to reach as a starting point such as having one cigar instead or two, and take it from there until you have given up completely.

A family history of high cholesterol should not be ignored and it may be that you have a genetic condition called familial hypercholesterolemia. You can find more information on the condition here. Take this to your GP for further advice as you may benefit from taking a statin. But a healthy lifestyle is a vital part of reducing your risk of developing heart disease in the future. I wish you the best of luck in reducing our alcohol intake and with quitting smoking.

Live chat with nurse Judy

Karen asks: “My husband had a heart attack at the end of January, he had a stent fitted, he was off work 3 weeks. He is now back to playing football twice weekly and golf, I say he is doing too much and should be taking it easy, wasn’t this a sign telling him to slow down. How likely is he to have another heart attack, he is 55.”

Judy says:

Your concern is understandable and is very commonly experienced by partners/spouses of someone who has had a heart attack. When I first started nursing it was common practice to keep patients in bed for ages following a heart attack. Now thanks to research we know that regular exercise is good for the heart, and that it’s an important part of the rehabilitation programme for those who have had a heart attack.

Lots of people ask us to quantify the risk of having a second heart attack. It’s impossible to do this but what I can tell you is that a healthy lifestyle, including regular exercise, can help to reduce the risk of another heart attack. It’s also important that your husband takes the medication he has been prescribed.

Another benefit of regular exercise is that it’s great for mental health and well being and can help boost the confidence of the person who has had the heart attack. So whilst I can fully understand your concerns it would be best to encourage your husband to keep active. Obviously if he were to experience symptoms such as chest pain or shortness of breath on exertion he should stop and rest and report it to his GP. But if he has no symptoms on exercise he should continue to enjoy it and all the benefits it brings.

Live chat with nurse Judy - we're back!

Lindsay asks: "Hi about three months a go I had an ablation on my heart which my consultant told me was successful, since the operation I have not felt very well and have found it hard to get around without feeling dizzy and off balance, also I keep getting a severe headache pulsating at the back of my head, so I went back to my consultant and had a 24hr tape put on and he has now diagnosed me with Inappropriate Sinus Tachycardia and put me on a tablet called Ivabradine 5mg twice a day. I’m still feeling really unwell and wondered if anybody could help, thank you"


Judy says "I am very sorry to hear of your considerable symptoms – it must be difficult to tolerate the headache you described. Ablation treatment for heart rhythms problems is usually reserved for those people for whom medication did work. In other words it is used for people whose rhythm and associated symptoms are difficult to control. Unfortunately it does not always work and sometimes a second attempt is needed or other medication. I suggest you keep in communication with your cardiologist who can continue to monitor your symptoms and make adjustments to your treatment accordingly. Sometimes it takes a while to identify the effective treatment for some people with heart rhythm problems – I hope yours will soon be under control and that you’ll feel better soon."

Thanks for your question, we hope that has helped.

Live chat with nurse Judy - out to lunch

Hi everyone, thank you for all the questions so far today, we have been inundated! We hope that the answers have helped you all.

Our nurse Judy is now on lunch and we will be back at 1:45 to answer more questions. Please keep the questions coming and we will try to answer as many as we can.

Thanks, see you all at 1:45.

Live chat with nurse Judy

Christine asks: "Hi my husband has heart disease, he had a quadruple bypass 5 yrs ago but 3 have closed already and only has 1 doing all the work, how long can this artery last?"

Judy says:

I am very sorry to read that your husband has had such bad luck so soon after his surgery. It’s impossible to answer your question to be honest – no one can predict how long before his symptoms will return. The rate at which the disease progresses to the viable bypass graft can be reduced with a combination of medication and a healthy lifestyle. It would be advisable therefore for him to take the medication he has been prescribed and to avoid smoking, eat a healthy diet (low in saturated fat and rich in fruit and vegetables) and to take regular physical activity.

I can understand that its a concern for you so you might find some support by joining our free service Heart Matters. Members receive a free magazine where we regularly feature articles on caring for someone with a heart condition. You might find it comforting to know that a lot of spouses/partners are in your position. I wish your husband good health and I hope that he will remain symptom free for a long time.

Live chat with nurse Judy

Sarah asks: My son was born with Tetralogy of Fallots and dissconnected pulmonary artery. He had a Fallots Repair two years ago, having the pulmonary artery repaired and a shunt fitted after birth. We have been told he will need further surgery as he grows to replace tubes with bigger ones. Around what age is this normally done? Also he has a very loud heart beat, is this normal?

Judy asks:

The age at which a child with a ‘repaired’ Tetralogy of Fallot (TOF) needs further surgery will vary from one child to another depending on the child’s symptoms as he or she grows. If you notice that he is playing less or complaining of being short of breath let your GP or paediatrician know. As a general rule, children with TOF will be seen regularly in clinic by their paediatrician so that their condition and symptoms can be monitored. We recently published a new booklet for parents of children with TOF. I’m not sure why his heart beat is loud – ask his GP for advice about this.

I hope your little boy is enjoying the summer with his friends and I wish him good look with any further surgery.

Live chat with nurse Judy

Barry asks: "How concerned should I be that my father's around 4 stone overweight - is this putting him at higher risk of heart trouble? Thanks"

Judy says:

You are right to be concerned about your dad’s weight – being overweight increases the risk of developing heart disease. If his weight is predominantly around his middle it will increase his risk of developing diabetes which in turns increases the risk of heart disease.

We may be able to help to motivate him to lose weight with our free Heart Matters service. On joining your dad would receive a free membership pack which includes a handy tape measure with instructions on how to measure his waist. The tape measure highlights the point at which an increased waist measurement increases the risk of heart disease – some of our members have told us that this motivated them to lose weight so that they went from the ‘at risk red area’ of the tape to the healthier white. Of course lots of people find eating healthily a chore so we have over 140 healthy but tasty recipes available to choose from our online recipe finder.

Our free heart matters magazine gives tips on staying active in ways that are both enjoyable and inexpensive. If you dad joins today he will receive our October issue of the magazine which has a fantastic article on dog walking. I hope he will give us the opportunity to support him in looking after his heart by joining Heart Matters.

Live chat with nurse Judy

Keri says: I am 31 and have SVT and up until few months ago was controlled by 50mg atenolol once daily. I had a major SVT event in june and since then I have minor ones daily,dizzy spells, am extremely fatigued and easily fatigued by simple things like housework or walking down stairs at tube station and have noticed fluid buildu...p which I brought up to my gp as we're waiting for my cardiology appointment in 3 weeks. He said my blood pressure is too low to give me anything for fluid its 102/80 and ordered blood tests and a 48hr holter test. My question is with the blood test and all the other symptoms is it possible I am entering heart failure? And what should I be keeping track of to tell cardiologist? At present its everything from svt events how often I get fatigued, dizziness etc.

Judy says:

I am sorry to read that you are so unwell at the moment. When the heart rate is fast and erratic it can lead to the symptoms you have described - low levels of energy on minimal exertion and shortness of breath. Whilst people with heart failure can experience similar symptoms those symptoms alone do not mean that you have heart failure. For most people, once their SVT is better controlled with medication they notice an improvement in symptoms. I hope that this will be case with you and your quality of life will improve soon. As for what you need to tell your cardiologist, what you’ve told us is what you need to tell him or her. A diagnosis will be made using information you give on your symptoms and the test results. Good luck and hope you’ll feel better soon.

Russell asks: I have a 47 year old sister with Downs Syndrome who has always had a slight heart murmur that has never caused any concerns. In the last 6 months she has been suffering from 'funny turns' when she describes her head as 'being funny.' She has undergone several tests including a heart scan and being wired to a heart monitor for 24 hours. The results showed that she has a thickening of the aortic valve that the doctors have told us is no cause for concern. Our family history includes a grandmother who had angina and died of a heart attack, our mother (she also had angina) who during a routine stent operation suffered heart failure and died ten days after the op from a heart attack, a sister (who at the time was 52) who had a massive heart attack and ended up in the bed next to our mum in coronary care. In total there are 9 offspring of whom 3 have heart problems and 4 who have high cholesterol. Gosh, we do sound a right lot don't we?! Our concern is that the valve problem our sister has, given our family history seems to have been dismissed. Should we be doing anything specific regarding this matter? If you could offer any advice we would be very grateful.

On a final note my whole family think you do a fantastic job! Although sadly mum couldn't be saved the care and attention mum, my sister and our whole family received from the staff on the coronary care unit at the Alexander Hospital in Redditch was second to none, they were truly wonderful. Our family did a sponsored walk in memory of mum and to say a massive 'Thank You' and we managed to raise £2,349 which we hoped show our appreciation in a small way.
I am so sorry to read that several members of your family have been affected by heart disease. Thank you for raising funds for us in memory of your mum which will help us to continue our work.

Judy says:

Down’s Syndrome is often associated with congenital heart disease so I am not surprised to hear that your sister has always had a murmur (an unusual sound which can be heard with a stethoscope). Its good news that your sister was told that the thickening to her aortic valve does not need to be treated right now. I am not sure why she is experiencing dizzy spells though so it would be worth revisiting the GP if it persists. Another option is to call an ambulance at the time of her dizzy spell. Your GP may be able to advise you further on this. I hope that your family will have better luck in the future.

Thank you for all the money you have raised for us, what an amazing achievement! Thanks for your question and we hope our answer helped.

Live chat with nurse Judy

Stan asks: "I had a triple heart bypass in April 2007, and over the last two years I have had a tight chest which at times causes me to become a bit short winded, I have told my Doctor of this about ten times over the last two years, Four months ago he thought that I had asthma, after having an asthma test everything was normal, he then sent me for an E C G which everything was normal, He then suggested that it is muscle caused by the operation, I decided to see another Doctor who as told me that it is cartilage which takes a long time to heal after such an operation, I have asked other people that have had the same operation and no one as had anything similar to what I am experiencing. In your experience have you ever come across anything like this, I am asking this because I am concerned about it."

Judy says:

"You are not the first person I’ve heard talking about reoccurring pain following surgery though it is not the norm for everyone. It is reassuring that your doctor does not think that it is related to your heart but that it is more likely to be related to the healing process. If the pain is causing you considering distress it may be worth asking your GP if he or she thinks it is appropriate to refer you to a chronic pain specialist. Hopefully you will not experience a heart attack in the future but should you get chest pain that feels different to the pain you described above you should call 999 immediately. I wish you good health for the future."

Live chat with nurse Judy

George asks: "I am 38 had my heart attack in october 2009 i continually keep getting back pain and colds as well as discomfort on my left hand sude while i am sitting down no fear over another heart attack but i am worried if this is normal or not and any suggestions about the cold."

Judy says:

"I am sorry to hear that you had a heart attack so young. Your symptoms are not common so I am not sure if they are related to your heart condition or not. Its not typical of heart disease to only experience pain on sitting down nor to suffer from head colds regularly. But I am not in a position to make a diagnosis for you or suggest what could be the cause of your symptoms.

It would wise to report your symptoms to your GP who could arrange tests for you. If you do expereince chest pain again you should call 999 immediately as it could be another heart attack. I hope that you will feel better soon. We have a range of booklets for people who have had a heart attack including: ‘heart attack’, ‘Returning to work with a heart condition’ and ‘cardiac rehabilitation’ which I hope you will find useful."

Live chat with nurse Judy

Anita asks: “Good Morning Julie, just a small question, my 7 yr old daughter had open heart surgery to close a hole and cut muscle bundles, 4yrs ago next month, but since the start of the year, 4 times, most recent few wks before the summer holidays started, she has said her heart hurts (her words). should i be concerned or is it normal? Thank you”

Judy says:

Congenital heart disease varies from one child to another so it hard for me to comment. However, I would say that given your daughter’s history it would be wise to take her to GP who could listen to her heart and examine her. If the GP picks up any issues he or she could refer your daughter for tests and back to the specialist team at the hospital for a check up. I hope your little girl will get a good report from the doctor and that she will enjoy the rest of her summer holidays from school.

Live chat with nurse Judy

Charlotte asks: "Hello. I have a 2 year old little boy who was treated for SVT as a tiny baby. We are off the meds he was taking and signed off by the Royal Brompton just over a year ago. My question is do you think for I should ask for a 24hr ECG to be done just to check all is as it should be?"

Judy says: "Generally children who have been discharged from hospital will be given advice as to whether or not they need to have regular check ups. If the doctors were happy to for him to be discharged then it is likely that he does not need regular follow ups.

A 24 hr ECG might be reassuing for you but it will just capture what is happening on that particular day and therefore is of limited value. If your child has normal energy levels and is playing as usual then that would be a good sign.We are not in a position to give individual medical advice but if you notice that his heart is racing again it would be advisable to take him to the GP or to call the paediatric unit at the hospital again for advice.

I hope that your little boy is enjoying playing with his friends and I wish him best of luck with his heart health in future."

Thanks for your question, we hope that helped.

Live chat with nurse Judy

Ian asks: "Hello Judy, i'm a TOF sufferer and had a valve replacement operation last year, but i am still suffering with incredible tiredness and lethergy, and i was wondering if there is anything you could reccomend to get over it."

Judy says: "Tetralogy of Fallot as you know is a complex congential heart condition. I am not sure why you are still feeling breatheless so long after the heart valve replacement. It may be unrelated to the surgery or you may be unlucky and having some unresolved complications as a result of it.

It would be advisable to see your cardiologist again who can arrange tests to look for the cause of the breathelessness.

Thank you for the question today. We hope that helped and that you feel better soon.

Live chat with nurse Judy

Lorraine asks: "Good Morning Judy, I have a heart failure condition as a result of a heart attack 5 years ago. The thing that gets me down the most is the tiredness. I do work through it as best I can but wondered if you had any other tips or if there is anything herbal i can take to help with it. Thank you."

Judy says:

I am sorry to read that you are exhausted because of your heart failure. It is not uncommon with people with it to feel good some days, and very exhausted on others. The trick is to try and pace yourself so that you do the same amount of exertion every day, rather than over doing it on days where you feel good, which then makes you feel wreaked for days afterwards. It is also good to keep in close contact with your GP or heart failure nurse who can tweak your medications regularly so that they work best for you.

We give tips like these in our booklet; "An everyday guide to living with heart failure" which includes a pull out personal medical record.

Lots of people ask us about herbal remedies but there are none that are proven to be effective in treating heart failure. Many herbal remedies interfere with medications for the heart so be careful about taking a combination of the two. It would be worth talking to your pharmacist before taking any herbal or natural remedies.

I hope that your symptoms will improve soon and that you can enjoy a better quality of life.

Jeannette asks:

"I have had 3 ASD closeures, at my check up a few weeks ago I was told that my pulse was racing and was put on more medication, what is meant by this and what are the implications."

Judy says:

It is not unusual for people to develop disturbances to their heart rhythm following heart surgery. Most of these disturbances are treated with medication which helps to control the symtoms and the rhythm itself.

There are many different types of disturbances to the heart rhythm and you can read about them in our booklet "Heart rhythms".

I hope the rest of your recovery will be stress free, and that you feel better soon. Thank you for your question today.

Live blog with nurse Judy

Linda Hill asked on Facebook:

"hiya judy, can I ask a question about me heart condition please, i have a bp of 200 over 170 and i have cardiomyopathy,my heart also is thickening due to the bp,i feel pooly and out of breath quite a lot and have bad palpitations is that caused by the thickening and he,s the biggy can they reverse the damage,im on a lot of medication to try to control my bp,ive also had 24hrs monitors and even when im a sleep my bp is surging in to the highs thanks :0) im 46."

Nurse Judy says: "Sorry to hear that you are not feeling very well. Cardiomyopthy is not a reversable condition, but the symptoms can be improved and controlled. Some people respond very well to treatment, but it depends on the type of cardiomyopthy you have have and whether or not you have any other chronic conditions.

Your blood pressure is still uncontrolled, so I would advice that you need to see your GP as soon as possible. It might be worth asking him to refer you to the cardiologist for more specialist support.

I hope you get better soon, thank you for asking your question. We have booklets on different types of cardiomyopthy - you can find out more on our website."

Live chat with BHF nurse Judy

Morning everyone, hope you are all well today.

Our live chat with our BHF nurse Judy O'sullivan is going to start at 10am. We can't wait to hear all your questions.

The live chat will be running from 10am to 4pm with a small break at lunch. We hope to answer as many questions as possible throughout the day.

You can submit a question in the following ways:

• You can email internet@bhf.org.uk
  
• You could post a question on our Facebook fan page


• Or you could tweet your question using the hashtag #BHFQs.

We will answer all the questions on this blog, so keep an eye out for your question and answer.

A ‘McStatin’ is not the answer

A study published this week in the American Journal of Cardiology, asks whether taking a medicine tablet can ‘neutralise’ the heart risk of eating junk food.

The authors suggest that people should get a complimentary sachet of the cholesterol-lowering drug, known as statins, when ordering foods such as a cheese burger and milkshake to offset the cholesterol raising effect of the junk food.

Popping a pill may seem like an easy way to look after your heart health – but it’s important people don’t take the findings of this study literally.

For starters, there are more health problems from eating junk food than just raised cholesterol. Junk food is often packed full of salt, which increases your blood pressure and your chance of having a heart attack or stroke, while the high calorie content can lead to weight gain, obesity, diabetes and heart disease.

So a pill that may negate the impact of junk food on your cholesterol will sadly do nothing to stop your blood pressure going through the roof or you piling on the pounds.

People should also know that this study is not based on a clinical trial where people were regularly given statins with burgers and milkshakes and monitored to see the effects.

The findings are based on applying the results of previous studies into the effect of junk food on raising cholesterol and the impact of statins on reducing cholesterol. There is currently no evidence that this would actually work.

The research assumes that every statin and every burger and milkshake would have the same incremental effect on your cholesterol – and we don’t know whether this is the case.

All published studies on statin-use are based on people taking them regularly, not once a week or once a month as they might if statins were dished out in fast-food restaurants. It’s not clear to me whether there would be any benefit from intermittent statin use in this way. The key factor in terms of heart health is likely to be life-time exposure to high cholesterol, something a single dose of a statin would have a negligible effect on.

Statins are very safe drugs and have been proven to reduce cholesterol effectively. They are a vital medicine for many people but we don’t know what the effect of uncontrolled statin-use would be. There may be unwanted side-effects for people with pre-existing illnesses and there are issues around responsibility if something did go wrong. Who would be responsible? The drug companies the restaurants or the people taking the pills?

The ‘McStatin’ is unfortunately no substitute for eating healthily and exercising. It’s fine to enjoy the odd burger or milkshake but we have to remember these are treats and not foods we should be eating every day.

Promoting a pill for junk food would lead us towards medicalising a huge swathe of our population when really people need to take more responsibility for their own health.

By Dr Mike Knapton

Associate Medical Director

Cold Heart

It’s a routine familiar to many of us. We wake up in the morning, peer round the curtains and check what the weather is doing.

If it’s cold we reach for our hat and scarf, and if it’s warm, shorts and sunglasses are order of the day.

But if you’ve got heart disease the weather can play a much more important role. In fact, a new study, funded largely by the BHF, has found colder than average temperatures may increase someone’s risk of heart attack.

Cold weather

Extreme cold weather can affect the heart by increasing heart rate and blood pressure. And chilly temperatures could also affect blood cells which could increase the risk of developing blood clots. A blood clot is often involved in the blocking of a coronary artery leading to heart attack.

So, if the weather forecast predicts plummeting temperatures then heart patients must remember to wrap up warm and wear several layers of clothing – including a hat, gloves and nice thick socks.

And it’s also very important to avoid sudden exertion. If you’re a heart patient and you need to shovel snow off your driveway or push the car, leave it to someone else. Even better, stay indoors and keep the heating on.

And remember to keep an eye on vulnerable friends, family and neighbours during those cold snaps.

Hot weather

At the opposite end of the spectrum, hot weather can also play its part in the lives of heart patients.

The advice is simple; don’t stay in the heat for long periods and make sure you drink plenty of fluids.

But why is drinking water so important? Hot weather can cause excessive sweating which increases the loss of fluid from your body and, in turn, reduces your total blood volume.

It means the workload on your heart and the demand for oxygen is increased, which can lead to angina if you have coronary heart disease.

It’s a running joke that we all love to talk about the weather, but it can play an important part in the life of anyone suffering from heart disease – the UK’s biggest killer.

By Ellen Mason, senior cardiac nurse

Getting heart healthy at the London Mela!

Statistics suggest that the South Asian community are 50% more likely to die from heart disease than those in the general population. But heart disease is often preventable and healthy eating, regular exercise and giving up smoking all have an important role to play. That’s why the BHF is visiting Melas across the UK and encouraging people to get more heart healthy.

Qaim Zaidi, Ethnic Strategy Co-ordinator at the BHF said:

“We can support people in making real differences to their lifestyle that are easy to maintain. Small changes now can have a big effect on future heart health. The BHF here to help, so just pop in and see us at any of the Melas we’re attending”

The BHF team had a great day at the busy London Mayor’s Mela yesterday with a range of visitors attending the stand. Multi-lingual BHF staff were on hand to give health advice and there are a host of fun contests and activities to take part in. Visitors were also encouraged join a range of free BHF clubs at the mela including the Artie Beat club for children between seven and eleven and the Heart Matters service for adults.

The BHF stand will be visiting the following events over the next few weeks:

• 14th August The Southwark Mix Burgess Park, Chumleigh Street,London SE5 0RJ

• 12th -15th August Bristol International Balloon Fiesta Ashton Court, Long Ashton, Bristol BS41 9JN

• 29th - 30th August Sandwell Show Sandwell Valley Country Park, West Bromwich, Sandwell B71 4‎

• 19th September Birmingham Eid Mela Cannon Hill Park, Birmingham B13 8RD

To find out more about our resources for the Asian community please visit our website.

Sugar content will remain high in Coco Pops, despite moves to make the cereal healthier

I doubt you’re really wondering about the sugar or salt content of your breakfast cereal as you sleepily tip it into the bowl first thing in the morning.

But yesterday Kellogg’s announced they intend to reduce the amount of sugar in Coco Pops by 15 per cent, saying they had “listened to mums”.

While we think the move by Kellogg’s is definitely a step in the right direction, Coco Pops and lots of other breakfast cereals on supermarket shelves will still be high in sugar, even after the reduction.

It may be hard to spot this though, because the information on food packaging can be so confusing. We don’t have a standard labelling system in the UK so we’re left comparing a confusing multitude of different figures and symbols to try and work out what’s really in the food we’re about to buy.

What we need is a clear and simple food labelling scheme that we can all understand. A system including traffic light colours on the front of packaging has been proven to give families the most helpful information to make at a glance decisions about what’s really in the food they buy.

Food companies have been extremely reluctant to consider traffic light labels, which makes us wonder what have they got to hide?

By Beatrice Brooke, policy manager for the BHF

• Find out why traffic light labels help make healthy choices into easy choices with our food label quiz.
• Join the debate on the BHF Facebook page