Local project shows promise in heart malady treatment
Steve Blackwell was a busy technical sales rep who dealt with a lot of travel and tight deadlines.
But he was health-conscious, he ate right and even managed to squeeze in three workouts at the gym almost every week. So the headaches, the congestion, the inability to sleep and the sheer exhaustion that crept up on him during his vacation in Arizona more than a year ago was just too much, and too strange.
“I remember golfing, and taking two steps up to the tee box but then having to sit back down and rest because I was just too tired.”
When he returned to Calgary, a checkup with his family doctor had him sent the same day to hospital, where he was diagnosed with congestive heart failure and admitted for six days.
Doctors determined something called viral cardiomyopathy, a condition in which the heart muscle is weakened and leads to diastolic heart failure. Blackwell was prescribed a series of medications to regulate his heartbeat, but months later was also provided with an implantable cardioverterdefibrillator, which sends a jolt of electricity to correct any life-threatening, irregular heart rhythms. “You can feel it right there,” says Blackwell, tapping a small, hard square underneath his skin. “It’s like an iPod in your chest.”
The 52-year-old is part of the Alberta HEART research project, now making significant advances in recognizing and treating diastolic heart failure, the least understood and toughest-to-diagnose form of heart failure.
The condition occurs when the heart fails to fill with enough blood because the heart muscle has become stiff. About 40 per cent of heart patients —roughly 32,000 Albertans — have diastolic heart failure, but it can only be confirmed through diagnostic imaging exams, such as echocardiography or magnetic resonance imaging scans.
Its symptoms — including chest pain, fatigue, weakness and swelling — are similar to those caused by the more common type of heart failure, systolic, which occurs when the heart muscle becomes too weak to pump with enough force.
“Diastolic heart failure looks like systolic heart failure when you’re examining someone at the bedside,” says Dr. Jonathan Howlett, director of Heart Failure at the Libin Cardiovascular Institute of Alberta and clinical professor of medicine at the University of Calgary.
“We’re trying to learn more about it so we can identify it earlier, prevent it from happening and treat it when we see it.”
Howlett explains that thanks to the research project, significant advances have been made in MRI imaging and doctors’ ability to examine the heart’s condition, how much blood it’s pumping and how significantly it’s been scarred.
More detailed diagnoses, Howlett adds, can lead to better, individual treatment geared to individuals.
Advancements also have been made in heart-regulating medications, including fluid pills, enzyme inhibitors and beta-blockers.
“There are many reasons why the heart fails,” explains Howlett.
It can be a combination of lifestyle issues, from hypertension, smoking, obesity, high blood pressure and diabetes, to uncontrollable genetic issues.
But for Blackwell, who had always led a healthy lifestyle, doctors fear his heart may have suffered damage from a serious flu virus months before he started experiencing symptoms.
“I remember it was a bad flu, it lingered for weeks, more than three weeks,” said Blackwell.
“That might have been what did the damage.”
Blackwell initially thought he was suffering from sleep apnea, but months later discovered it was a heart condition, well after much of the damage had already occurred.
Alberta HEART — consisting of 24 scientists and clinicians across the research and health-care spectrum — is creating strategies to diagnose patients like Blackwell much earlier.
Partners in the fiveyear project, now in its fourth year, include Alberta Health Service, the University of Alberta, the University of Calgary, the Libin Cardiovascular Institute of Alberta and the Mazankowski Alberta Heart Institute, with $5 million in funding from Alberta Innovates — Health Solutions.