What causes heart failure: heart attack and angina

Most of the people we talked to did not know what had caused their heart failure, though many realised that the heart could be affected by many things. It was not always important for everyone to know what had caused their heart failure.

This section concentrates on the experiences of those who said their heart failure was caused by coronary heart disease and heart attacks. (For cardiomyopathy and valvular disease see ‘Other causes of heart failure’.) A few also interpreted heart failure as meaning that their heart – like them – had simply grown old.

Heavy smoking is a known risk factor for heart failure. Several older men had started smoking when they were teenagers and had maintained the habit until middle age. A retired miner who took up smoking when he was 14 said he had had a heart attack at 46 and had managed to give up smoking years later when he retired.

He started smoking aged 14 and gave up when he retired.

Age at interview 75

Gender Male

Age at diagnosis 65

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About half of all those diagnosed with heart failure already have coronary heart or artery disease which is generally thought to be linked to smoking, eating a high fat diet and taking too little exercise. Several people acknowledged that eating too much, drinking too much alcohol and working too hard had played a big part in their heart problems.

He thinks that working too hard and living life to the full led to a heart attack.

Age at interview 74

Gender Male

Age at diagnosis 73

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Damage to the heart caused by one or more heart attacks can also lead to heart failure, and this was common amongst those we talked to. Some had been able to take early retirement, but others could not afford to stop work and had changed to less physically demanding jobs. Some said that having a heart attack had frightened them into giving up smoking straightaway; changes in drinking and eating habits and trying to exercise more regularly were also common.

Having heart failure forced him to look for a less physical job.

Age at interview 47

Gender Male

Age at diagnosis 41

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Several people had been told they had had ‘silent’ heart attacks and not known about them until other symptoms prompted medical tests; for instance one woman who went into heart failure after bouts of vomiting was told she had probably had a silent heart attack and known nothing about it at the time. Most people with heart attacks have obvious chest pain but some, especially women, may have other symptoms such as vomiting, breathlessness or fatigue without pain; this is known as a ‘silent heart attack’ (see also Heart attack site). A few who had high blood pressure said they had been given medication but did not necessarily connect it with heart failure.

Her ‘silent’ heart disease presents itself as serious vomiting and nausea.

Age at interview 59

Gender Female

Age at diagnosis 55

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Several people experienced pains in their chests and arms both before and after diagnosis. Some referred to their pains as angina, but did not necessarily see it as a contributory factor in heart failure.

A few people saw heart failure as part of growing old and as the result of ordinary bodily ‘wear and tear’. Not everyone used the term ‘heart failure’ ro describe their heart problems), which they said they half-expected because of their age (see also ‘People’s ideas about causes of heart failure’).