The link between heart failure and mental health


Upon first consideration, you may think that heart health and mental health have no connection. However, your mental health can affect your heart, and your heart health can, too, affect your mental wellbeing.

An article published by Harvard Health in 2018 reported that individuals living with depression or anxiety are more prone to developing cardiovascular disease. Factors known to contribute to a higher risk of heart disease, including an unhealthy diet, a lack of exercise, and smoking, are also common in people with poor mental health.

Cardiovascular disease can often result in congestive heart failure, and it’s estimated that many people do not yet know that they are suffering from this illness, according to the Ted Rogers Centre for Heart Research. At present, over one million Canadians are affected by heart failure, with 50,000 people being newly diagnosed each year.

“Mental health disorders and cardiovascular problems might not just co-occur in adulthood. Instead, people may be vulnerable to both conditions over a lifetime because of their early exposures,” Dr. Jill Goldstein, a professor of psychiatry and medicine at Harvard Medical School, told Harvard Health. Living with depression or anxiety has an impact on heart failure, and it can affect how you manage your illness.


Depression is a constant feeling of dejection and loss that stops you doing your normal activities. The Heart and Stroke Foundation states that the two main signs of depression are a low, sad mood, and/or loss of enjoyment or interest, on most days for at least two weeks. Everyone feels depression differently — some patients may experience trouble sleeping or a general feeling of tiredness and low energy, but in all cases, it’s important to recognize it and treat depression.

Many forms of poor mental health can affect the heart, including depression. An article for The Washington Post by Dr. Nathaniel P. Morris, resident physician in psychiatry at the Stanford University School of Medicine, states that the U.S National Center for Biotechnology Information has discovered that between 17 and 44% of patients with coronary artery disease also have major depression. “As many as 40% of patients undergoing coronary artery bypass surgery suffer from depression.”

When patients are sick and under stressful circumstances, it can foster depressive symptoms. “But depression itself is also a risk factor for developing heart disease. Researchers aren’t sure why, but something about being depressed — possibly a mix of factors including inflammatory changes and behaviour changes — appears to increase the risk of heart disease,” Dr. Nathaniel P. Morris reports.


Anxiety is one of our most common emotional experiences and it's the normal, healthy reaction to a threat. The Heart and Stroke Foundation explains that, when you become nervous or stressed, part of the anxiety response is to speed up the heart. “Most of the time this is healthy and keeps us safe. However, anxiety can get to the point where it isn’t healthy. It can become an anxiety disorder that damages the quality of people’s lives, keeping them from living a normal life, and it needs to be treated.”

This could be in the form of generalized anxiety disorder, when a person believes there is danger in almost any situation and develops feelings of anxiety about most things in life, such as family life and work, or a panic disorder, when someone has recurring panic attacks that start suddenly and reach a peak within a few minutes. PTSD (post-traumatic stress disorder) and phobias can also cause feelings of anxiety to rise.

It is common for individuals to develop anxiety or depression when living with heart failure as the illness can trigger stress when symptoms worsen.

Support for heart failure patients

Although there is currently no cure for heart failure, many patients can improve how they live with the illness by making lifestyle changes such as eating heart-healthy foods, learning to reduce stress, exercising regularly, getting enough sleep, and quitting smoking. Medications and medical devices can also help manage the symptoms of heart failure, as reported by the Heart and Stroke Foundation.

Due to the stigma often associated with mental illness, many people avoid or delay seeking treatment. However, Health Canada advises that if you are experiencing signs of mental illness, it’s important that you seek help as soon as possible. If a loved one, friend, or colleague close to you is showing signs of poor mental health, talk to them about getting help.

Don’t be afraid to reach out to your family doctor, a psychologist, mental health nurse, counsellor, or social worker, to ask for help. There are also online support and resource options available from the BC’s Heart Failure Network and of course our closed HeartLife Foundation Facebook Support Group.

Talking about your feelings of sadness, anger, frustration, and even excitement, can help lower feelings of anxiety. Remember to care for yourself, be proud of your strengths, and accept your limits — without blame or criticism.


TEC4Home: Improving self-care management for heart failure patients


As the evolution of Canada’s healthcare system continues, an increasing number of Canadians are surviving heart attacks and other acute cardiac conditions, consequently increasing their susceptibility to developing chronic heart failure, as reported by the Heart and Stroke Foundation. At present, there is no cure for the illness, and symptoms can be unpredictable, resulting in frequent visits to the hospital emergency department (ED) for many patients.  

The Heart and Stroke Foundation highlights the staggering statistics; one in five heart failure patients will be readmitted to the hospital within one month of discharge, and 40% will be readmitted within four months. So, how can a patient’s quality of life be improved?


To help reduce unnecessary ED visits, the Department of Emergency Medicine at the University of British Columbia (UBC) began a randomized controlled trial of home health monitoring (HHM) for heart failure patients: TEC4Home Heart Failure. This four-year initiative, funded by the Canadian Institute of Health Research, the Michael Smith Foundation for Heath Research, the BC Ministry of Health and industry partner TELUS Health, aims to demonstrate the application of technology in Heart Failure patient remote monitoring. TEC4Home is one of many HHM projects across the province that is looking at monitoring heart failure patients. Other HHM projects have included programs around COPD and Diabetes. HHM is currently active across five different health authorities in British Columbia.


Now in phase two, a randomized controlled trial, TEC4Home is recruiting patients from 20 hospital sites across Fraser Health, Interior Health, Providence Healthcare, and Vancouver Coastal Health. Over a 15-month period, the target number of patient participants is 900, which will be split into two groups of 450 — a control group and an intervention group. 

Here at the HeartLife Foundation, we were excited to play a role in recruiting patients for the TEC4Home Patient Advisory Committee (PAC). The PAC is comprised of heart failure patients from across BC. This committee provides feedback and guidance to the research team on the patient experience and patient educational materials. We are also working with the research team on a presentation to be given at the upcoming e-Health Conference in May 2019, on the role of patients in research. 

How TEC4Home works

The TEC4Home study focuses on the role of home health monitoring in the transition of heart failure patient care from the hospital to the home. Participating patients are given a home health monitoring kit by TELUS Health, which includes a tablet, weight scale, blood pressure cuff, and pulse oximeter to collect biometric measurements daily for 60 days post-hospital discharge. By tracking blood oxygen levels, weight fluctuations, pulse, and blood pressure, patients are educated on the importance of symptom awareness for illness self-management. 

Additionally, patients are prompted to answer a series of daily symptomatic questions, recording their answers on the tablet provided. The daily results are reviewed remotely by a monitoring clinician who calls each patient to check-in, prioritizing patients exhibiting abnormal symptoms. Under this care model patients have direct daily clinical input on their condition and can avoid unnecessary readmissions to the ER or other hospitalizations.

The results for phase one, a pilot study involving consecutive patients with Heart Failure from three hospitals including Vancouver General Hospital, St. Paul’s Hospital and Kelowna General Hospital, suggested a “59% reduction for heart failure re-admission, a 44% drop in ER re-visits, a 44% reduction in cost per patient, and 100% improvement in patient self-reported quality of life.” The current 20-community randomized controlled trial will hopefully validate these beneficial effects on a larger scale.

Cardiac patient and participant in the TEC4Home trial, Joy Gaze, describes the home health management program as somebody else looking after her, “it’s like a guardian angel,” she says.



Cardiac device implants in Canada: Are they worth the risk?


Heart failure is the most rapidly rising cardiovascular disease in the country and 1.4 million Canadians are admitted to hospital with the illness each year, as reported by the Ted Rogers Centre for Heart Research

There is currently no cure for heart failure, however, individual treatment plans and implantable cardiac devices such as pacemakers and cardioverter defibrillators (ICD), are being used to help improve patient quality of life. 

The Heart and Stroke Foundation details how a pacemaker is implanted during a surgical procedure, to treat abnormal heart rates or rhythms (arrhythmia) if a patient has not responded to medication. Meanwhile, an ICD is implanted to regulate irregular heart rhythms and transmits electrical signals to and from the heart muscle. 

“Patients with implanted heart devices are seen regularly, so that information can be retrieved from the device and health professionals can adjust the device to ensure it is working optimally,” as stated in an article on Remote Monitoring of Cardiac Devices, published by the Canadian Agency for Drugs and Technologies in Health

Poorly tested implants

When patients have a device implanted, followed by regular checks, they should be able to live a normal, healthy life, but that’s not always the case. The International Consortium of Investigative Journalists (ICIJ) recently released the first-ever global examination of the medical device industry and its regulators, revealing how health authorities around the world failed to protect millions of people from poorly tested implants. 

The Implant Files investigation has, according to CBC News, influenced a growing number of countries to say that they will “better track medical implants and warn patients faster by creating or expanding medical device registries.” After 30 years of failed proposals in Canada, Ottawa appears to be warming up to the idea of a registry. However, Health Minister Ginette Petitpas Taylor wants to make sure that the information collected is useful to Canadians.

Of the 10 devices which were tied to the most reports of death from 2008 to 2018, CBC News reports that 62 were caused by automated external defibrillators, 93 by ICD, 59 (pulse generator) pacemakers, 51 (lead) pacemakers, 82 tissue heart valves, and 31 mechanical heart pumps (VAD). 

Lobbying for a registry 

For more than 10 years, the Canadian Cardiovascular Society (CCS) has been lobbying for a registry. CBC News explains how the CCS created its own reporting system by keeping in contact with manufacturers. They also have expert committee review advisories, issue guidelines for surgeons, and survey hospitals about failure rates nationwide.

Chief executive officer of the CCS, Carolyn Pullen, told CBC News that the “transparency, accountability, and really important communication mechanism is a big gap in our health system.” The CCS reportedly contacted a senior official at Health Canada to offer input and expertise, however they received little interest, which the society said is “alarming.” 


Navigating the holidays with heart failure: What you need to know


The holiday season brings many opportunities to catch up with friends and family, to celebrate the completion of a successful year, and enjoy delicious food. It also increases the need to take time out to relax. 

When your regular routine is disrupted with a full calendar of activities and events such as family get-togethers, decorating, shopping, and meal prepping, it’s no surprise that the festive season can make one feel overwhelmed and stressed. In turn, these stresses can affect those living with heart failure. 

Here in Canada, the cold weather brings higher risk for heart failure patients as it can lead to increased blood pressure, which in turn raises your risk of stroke, as reported by the Heart and Stroke Foundation. Despite this, maintaining healthy lifestyle habits can help you navigate the festive season as stress-free as possible. 

Devise a plan to manage your energy

Heart failure affects each patient differently, so to help navigate the holidays, plan your time in advance to best manage your energy. This could mean visiting friends and family for one hour, scheduling in a rest break, and then returning for dinner or another visit. It’s a compromise that can help you preserve energy for upcoming social events during the holidays. 

Continue to exercise

Staying indoors for long periods of time can make anyone feel lethargic. Exercising helps keep your heart healthy and boosts feel-good endorphins that help you manage stress. Find a way that works for you whether it’s taking the dog for a walk after dinner, going swimming at your local community centre, doing a yoga class, or taking to the slopes for winter skiing. The only bad workout is the one that didn’t happen. Start slow and build up, even 10 minutes a day can make a difference.

Change gift and cooking expectations 

Thinking about the friends and family you have yet to visit and the gifts you need to buy can make you feel stressed. Simplify your approach by lowering your expectations. Buy gifts online, many companies even gift wrap and deliver for you, or organize a gift exchange with your family so that there’s less pressure for everyone.Going out for dinner or splitting cooking tasks with your guests gives you more time to rest. Freeze leftovers for easy meals when you are recovering from a gathering. Consult our guide on how to eat healthy with heart failure for more information. 

Stay hydrated 

Turning your heating up high or lighting the fire naturally increases the temperatures in your home to a level that you’re not typically used to. This can increase your body heat which is why it’s important to stay hydrated throughout the day by drinking water. Decrease your intake or avoid consuming caffeinated drinks like soda and coffee, drink water instead. 

Make sleep a priority 

Visits to friends and relatives often take longer than anticipated, and they can result in increased tiredness. Make sure to get enough sleep, even if you get home late. Plan a quiet, later start to the next day. The Heart and Stroke Foundation explains how “shortchanging yourself on sleep can leave you feeling cranky, raise blood pressure levels, and even lead to overeating.” 

Be present in each moment 

Oftentimes, the holiday season passes faster than you could have anticipated. Being present in each moment and mindful of how your body is reacting to what’s happening, allows you to better understand how you’re feeling. Moreover, it can help you improve the way in which you take care of yourself and appreciate the special moments with your loved ones. 

Say “no” when you need to 

Friends and family know you don’t have superhero powers so don’t be afraid to pass on events if you feel anything is too much. Focus on how you’re feeling and listen to your body when it feels stressed or needs rest. If you’re feeling lonely or isolated, reach out to friends or family for support — don’t be afraid to ask for help. 

We hope you have a wonderful, safe holiday season, and we wish you good health and happiness for 2019. 


7 Ways to prepare for emergency situations with heart failure


It’s estimated that one million Canadians are living with heart failure, and many do not yet know that they’re suffering from this chronic illness, according to the Ted Rogers Centre for Heart Research

The Heart and Stroke Foundation reports that "heart failure is on the rise as more people are surviving heart attacks and other acute heart conditions." There is currently no cure for this condition. However, when heart failure is diagnosed early, patients can live a full life by making changes to their lifestyle and working with their medical team to develop and follow a treatment plan that is best for them. 

On a daily basis, people living with heart failure need to monitor their weight, fluid intake, diet, and activity. In addition, it’s important to watch for signs of swelling in your feet, legs, ankles and stomach. All heart failure patients should be familiar with the Heart Failure Zones checklist published by the Heart and Stroke Foundation. This tool will help you to identify symptoms which require medical attention.

It’s incredibly important that you’re prepared for emergency situations when you have heart failure. We’ve compiled a list to help you get started. 

Know the warning signs 

Men and women can experience different signs of emergency with the heart. If you start to feel pressure or heaviness in your chest, notice that you are sweating more than usual, that you have shortness of breath or feel light-headed, call your medical professional or 9-1-1 immediately. Refer to the Heart Failure Zones for a complete list of symptoms in the yellow, caution zone and the red, danger zone.

Always carry your smartphone with you 

Keeping your smartphone in your pocket or your bag at all times, means that you can easily access it in an emergency situation. Add your family, friends, caregiver, and your doctor to your speed dial to expedite making contact with them. 

Make a list of your medications 

If you experience an emergency, those around you may not know the medications you’re currently taking or those that you're allergic to. Write down a list detailing this information with your emergency contacts listed below it and keep copies in your wallet, car, and at home.

Give instructions to your family and friends 

Explain all heart failure warning signs to your family and friends, and what they can do if you experience these signs. You could also encourage those close to you to take a cardiopulmonary resuscitation (CPR) class which will help them provide you with assistance in the event of an emergency, before an ambulance arrives.

Consider creating a medical “go bag” 

Harvard Health recommends creating a bag that you or a loved one can grab in an instant. Your “go bag” could include your legal documents, a list of medications, recent test results, and a supply of emergency medications and/or devices. Keep this bag somewhere in your house so that you and your family members will be able to access it with ease. 

Keep a source of glucose close-by 

If you’re diabetic, it’s vital to keep a quick-acting source of glucose with you such as juice or candy, in case you experience a drop in your blood sugar. Harvard Health suggests carrying a blood glucose meter at all times so you can check your blood sugar levels and avoid medical emergencies. 

Know your numbers 

As a heart failure patient, it’s important that you know what your typical blood pressure (BP), heart rate, etc. are. For example, it may be typical for you to have a BP reading of 80/50, but this may be treated in error as low in a medical emergency, or conversely, a reading of 120/80 may be considered normal when in fact for your situation it may require investigation. Apps such as Heart Failure Storylines let you record and monitor your vitals on your smartphone.

“As it stands, heart failure is a leading cause of inpatient hospitalizations, with newly diagnosed patients spending over 26 days of hospital resources in their first year of treatment,” according to the Ted Rogers Centre for Heart Research. Why not make emergency preparedness a New Year’s resolution? — it’s definitely worthwhile.


Winter with heart failure: Things to be mindful of this season

Winter is a beautiful time of year in Canada with glistening snowfall, beautiful snow-capped mountains, and frozen lakes and rivers. However, our winters are also long, and often harsh, in much of our country. The cold season increases the risk of dangers for everyone, and for those living with heart failure, this is especially so. Contending with strong winds, heavy wet snow, ice and extreme temperatures can place undue demands on our hearts.


Low temperatures can cause blood vessels to narrow, restricting the flow of blood around the body, and so reducing the amount of oxygen reaching the heart. This means the heart needs to work harder to continue pumping enough blood and oxygen around the body, as reported by Keep It Pumping.


Rapid drops in temperature can lead to worsening heart failure symptoms, a higher risk of hospitalization, and an increase in risk of death for heart failure patients. For this reason, it’s crucial to take precautions and be aware of the risks winter brings for heart health. The following tips can help you stay safe from the cold this season.


Reduce your exposure to cold

Avoid the impact of cold weather by reducing the amount of time you spend outside. If you are outdoors make sure to dress warm with several layers. This includes wearing a coat, hat, gloves, and warm footwear. If you find your breathing affected by the cold, try wrapping a scarf around your face. People taking beta blockers often have cold hands and feet, so you may need two pairs of socks and mittens instead of gloves.


Stay active during winter  

It can be hard to stay physically active when the cold weather hits. But by decreasing our physical activity, we’re essentially ‘hibernating’ our hearts, according to Health Canada. Hearts need regular exercise during winter and you can do simple exercises at home, take short walks, practice yoga, or strength training. Other options include walking tracks, mall walking, pools, or community centre fitness programs. Be sure to stay hydrated before, during, and after you exercise.


Keep your home heated  

Stay warm by heating your home to 18°C or higher. Open blinds or curtains to let as much natural sunlight in to each room as possible, and check sealing around doors and windows to minimize draughts. Using an extra blanket or a hot water bottle may be helpful during colder periods.


Don’t become overheated

During winter, you don’t want to find yourself sweating if you are outside because this signals that your body is overheated. If your body can’t release the extra heat it will lower your blood pressure, reducing blood supply to the heart. If this happens, remove layers until you cool down and/or take the time to go indoors and let your body readjust to a warmer temperature. It’s important to check with your medical practitioner to find out if you should be shovelling snow, most people living with heart failure will be advised to refrain from shovelling to protect your heart health.


 Maintain a heart healthy diet

The holiday season is generally filled with parties and family gatherings where food and wine are plentiful. “It is recommended that all patients with heart failure completely abstain from alcohol,” as reported by the Ted Rogers Centre for Heart Research. However, there are many festive non-alcoholic drink recipes available online. If you have diet restrictions try snacking on protein rich food before going out to keep your portions small and minimize sodium and sugar intake.


Be prepared for snow days

Check your local weather forecast regularly for weather that may impact your ability to get out. It’s important to have a supply of your prescriptions on hand to see you through any winter storms.


Reduce your risk of flu  

Flu season can cause a myriad of complications for heart failure patients, which can be potentially life-threatening. Flu shots are strongly recommended for heart failure patients. Your doctor may also recommend a pneumonia shot. Make sure to speak to your doctor immediately if you’re experiencing flu-like symptoms such as a fever, vomiting, or congestion.


There may be days during winter when braving the cold isn’t an option. If the temperature drops below -40°C, it’s often caused by wind chill, and you are best to take shelter indoors and exercise at home, according to Health Canada.



Eat well: 3 Heart-healthy recipes for fall


Autumn brings shorter days, longer nights, and a drop in weather temperatures that makes you savour those cozy nights in. That’s why it’s a wonderful time of year to try out new, seasonal recipes that are healthy for your heart.

“You may find eating with heart failure is a bit of a balancing act. While you don’t want to eat too much, you have to be sure to eat enough to maintain good nutrition,” as stated in the Nutrition Guide for Heart Failure by the University of Ottawa’s Heart Institute.

Living with heart failure requires a thoughtful approach to cooking, it’s something you become more familiar with over time. Nonetheless, with some advanced planning, consulting recipes, and picking up the fresh ingredients you need, you can make dishes that you, your family, and friends will enjoy this season.


Cooking at home lets you monitor your ingredient usage and amounts which is vital when you have heart failure, also if you are diabetic or have a sodium restriction. A healthy, balanced diet helps maintain your heart health and lower any potential risks. Since fruit and vegetables are packed with nutrients, you should aim for seven to ten servings per day, according to the Heart and Stroke Foundation.


Making fall-inspired dishes with natural ingredients can also help improve your cholesterol levels, reduce your blood pressure, and help you manage your body weight. Plus, you can have a lot of fun getting creative in the kitchen and you don’t need to be the next Master Chef to do so!


Here are three easy-to-make recipes for fall from the Heart and Stroke Foundation and The Mikey Network.  


Corn, Potato and Shrimp Chowder


Serves: 4


·      2 tsp vegetable oil

·      1 sweet onion, finely chopped

·      1 clove of garlic, minced

·      1 tsp dried dill weed

·      1 potato, peeled (cut into ½ inch cubes)

·      1 tsp ground pepper

·      1 ½ cups Corn kernels, fresh or frozen (thawed)

·      2 cups water

·      ¼ cup all-purpose flour

·      2 cups 1% milk

·      1 lb raw, medium size shrimp (shell off)

·      1 tsp lemon zest, grated

·      3 tsp lemon juice, freshly squeezed



  1. In a large pot, heat oil over medium heat.

  2. Sauté onion, garlic, and dill weed, for about 5 minutes or until the onions are softened.

  3. Stir in potatoes, corn and water; bring to a boil over high heat.

  4. Cover the pot, reduce heat to medium-low, and simmer for 5-10 minutes or until the potatoes are almost tender.

  5. Increase heat to medium.

  6. Whisk flour into the milk and gradually stir this into the pot. Stir gently.

  7. Stir in shrimp. Simmer uncovered while stirring gently but often for about 5 minutes – until the shrimp are firm and pink and the soup has thickened (do not let this boil).

  8. Stir in lemon zest and juice.

  9. Season with pepper to taste.


Grilled Chicken Barley Bowl

Serves: 4


·      1/2 cup (125 ml) pearl or pot barley

·      2 cups (500 ml) baby arugula

·      4 carrots, sliced lengthwise

·      2 red peppers, quartered

·      2 boneless, skinless chicken breasts (about 1 lb/454 g)

·      2 tsp (10 ml) canola oil, divided

·      1 tsp chili powder

·      2 tsp (10 ml) balsamic vinegar



  1. In a small saucepan, cover barley with water; bring to a boil.

  2. Reduce heat and simmer for about 20 minutes or until barley is tender but still chewy. Drain well and toss with arugula; set aside.

  3. Spray carrots and peppers with cooking spray; set aside.

  4. Toss chicken breasts with 1 tsp (5ml) of the oil and chili powder to coat.

  5. Heat grill to medium-high heat and grill carrots, peppers and chicken breasts for about 7 for the vegetables and about 12 minutes for the chicken. Turn occasionally until vegetables are tender and chicken is no longer pink inside. Remove to cutting board.

  6. Slice carrots and peppers; toss with remaining oil and vinegar.

  7. Divide barley mixture among 4 bowls and top with vegetables.

8. Slice the chicken and place over top to serve.

Apple Cranberry Crisp

Serves: 6


·      ½ cup dried cherries (or raisins if not available)

·      zest of 1 whole orange or lemon

·      1 cup sugar (or Splenda if desired)

·      1 tsp flour

·      ½ tsp ground ginger

·      ¼ tsp salt

·      3 large Granny Smith apples, peeled, chopped (about 4 cups)

·      6-8 oz cranberries, fresh or frozen, cleaned, rinsed, drained



·      1/2 cup panko crumbs (Japanese breadcrumbs) – use regular if not available

·      2 tsp brown sugar

·      ¼ tsp ground ginger

·      2 tsp butter, melted



  1. Preheat oven and prepare baking pan – use a 10″ quiche dish.

  2. Soak the cherries/raisins if needed in ½ cup warm water for 20 minutes, drain. Combine them with the fruit zest in a small bowl.

  3. In a large bowl, mix together, sugar/Splenda, flour ginger and salt.

  4. Into the bowl, stir in the apples, cranberries, and dried cherries/currants and the zest.

  5. Turn this into the prepared baking pan.

  6. In a small bowl, mix together all the topping ingredients.

  7. Sprinkle over the top of the fruit.

  8. Bake for 45 minutes until bubbly and many of the cranberries have popped.

  9. Serve warm alone or topped with ½ cup low-fat frozen yogurt.



If someone you love has been diagnosed with heart failure, you’ll want to read this


Each year, 60,000 Canadians are diagnosed with heart failure, as reported by the Ted Rogers Centre for Heart Research. One in two Canadians have been touched by heart failure and the support offered by family members, friends, and other caregivers can often make a difference in the quality of life for heart failure patients.


Carers or family caregivers, take on an unpaid support role for those living with chronic heart failure. In Canada, there are 750,200 carers providing social and emotional support; and sometimes physical care for loved ones with a cardiovascular disease, as reported by Carers Canada.


Burden, stress, and depression are associated with the caregiving role in the heart failure population. However, no two cases of heart failure are the same and each patient requires a different level of support depending on their unique situation.


We recently spoke with three Canadian caregivers who kindly shared their perspectives of heart failure with us (link to first post). Before the interviews ended, we asked each individual what they would say to someone whose loved one was recently diagnosed with heart failure.


Here’s the advice they have to share with you.


Erin Cherban: “It is critical that you attend appointments with your partner as your emotional states will make it difficult to comprehend what you are being told – take notes at appointments. If you feel frustrated with the information you receive, the appointments you are asked to attend, or any aspect of the healthcare journey, make sure you reach out, ask questions, and get clarification.”


“You will need to be your partner’s advocate. Also, if any of medical staff suggest that you look at specific books or use services, read or use them, they will help.”


Lyndall McCormack: “A support system is important, and friends and family are wonderful for that, but I was blessed to have another caregiver (the wife of another recent LVAD recipient) who met me for coffee while our spouses were having tests or appointments.”


“It was a freeing experience to be able to speak candidly with someone in the same position, going through the same things. We could say anything to each other, express how frustrated we were with our husbands or the doctors, and totally understand where we each were coming from.”


Mrs. Bloggs*: “It [heart failure] is not a death sentence. Read, get informed, learn, but don’t believe Dr. Google or everything that is on the internet. Get involved in online support groups for people living with heart failure. Don’t be afraid of asking questions and questioning answers.


“Get organized with a note-taking system as there will be a lot to learn. This is a roller-coaster ride. Enjoy and rejoice during the coasting times and pull up the big girl pants for the other times.”


The name *Mrs. Bloggs was used solely for the purpose of this article.




Dining out: How to eat healthy with heart failure


Heart failure has many potential causes such as high blood pressure, excess body weight, high cholesterol, and also diabetes which plays a role in several ways. The connection between diabetes and heart failure starts with high blood sugar levels.  

“Over time, high glucose in the bloodstream can damage the arteries, causing them to become stiff and hard,” as reported in an article by Dr. Mansoor Husain, executive director for the Ted Rogers Centre for Heart Research at UHN. “Diabetes accelerates atherosclerosis (hardening of the arteries), which can lead to heart attacks and stroke, contribute to dementia, and cause kidney damage and failure. The increased incidences of hypertension, heart attacks, and kidney disease in those with diabetes makes them particularly vulnerable to developing heart failure.”   

Individuals with diabetes may develop heart disease 15 years earlier than those without the chronic condition, according to Diabetes Canada. If you have heart failure, accompanied by diabetes or not, it’s important to maintain a healthy diet to lower any potential risks. A healthy diet is made up of mostly whole or natural foods and can help you improve your cholesterol levels, reduce your blood pressure, help you manage your body weight, and control your blood sugar, according to the Heart and Stroke Foundation.

You might find it easy to eat a heart-healthy diet when you’re at home, but what happens when you dine out a restaurant or go on vacation? We’ve compiled a list of guidelines that can help.


Speak with your server

Many restaurants and eateries prepare food for special diets on a daily basis. You can ask your server’s advice to help you select tasty, low-fat, healthy dishes. Find out how each dish you would like to order is prepared. Avoid heavy sauces and fried foods where possible.


Carefully choose your main dish

 When ordering your entrée, it’s best to choose a low-sodium option such as grilled, baked, poached, or broiled skinless chicken, fish, or lean meat. “Too much sodium makes your body hold on to extra water. This makes your heart work harder because it has to pump the extra fluid around your body,” according to HealthLink BC.


Specify side dishes

When it comes to your side dishes, opt for salads and steamed vegetables to best complement your entrée and help you stay on track with healthy eating. You can also ask your server for low-calorie dressings and toppings. If this is not possible, request for dressings to be served on the side so you can manage usage.

Time insulin if needed

Sometimes, you will be waiting longer than expected for your meal to arrive. If you have diabetes, check in with your server or host and time your insulin injection appropriately if you know your meal is going to be delayed. At this point, you may need to eat a piece of fruit or bread to keep you going until your meal is ready.


Manage your portion sizes

Oftentimes, food portion sizes at restaurants or a friend’s home will be bigger than you would normally prepare for yourself. Only eat as much as you would like, don’t feel obliged to clean your plate. You can always take the rest home with you and enjoy it at your own pace.


Leave or split dessert

Desserts and baked goods such as cakes, candies, chocolate, cookies, doughnuts, ice cream, muffins, pastries, and pies, are high in added sugar, according to the Heart and Stroke Foundation. Heart and Stroke recommends that you consume no more than 10% of your total calories per day from added sugars – ideally less than 5%. So, if you really want to have dessert, get someone to split it with you.  

Maintaining healthy eating habits and lifestyle choices has the potential to help you live a longer, healthier life with heart failure.



Finding strength amid frustration: A caregiver’s perspective of heart failure


One million Canadians have heart failure, the most rapidly rising cardiovascular disease in Canada, as reported by the Ted Rogers Centre for Heart Research. That’s one million people who have been diagnosed with an illness, for which in 2018, there is no cure.

Frequent hospital appointments, daily medication, monitoring your diet, and taking extra precautions when travelling, suddenly become part of your life. Because of this, heart failure patients often require assistance from a caregiver; a spouse, family member, or friend.

Having the support of a caregiver can contribute to a heart failure patient’s own self-care. “The availability of a spouse or other family relative is likely to be of benefit to the CHF patient in improving overall quality of life of the patient and in assisting the medical management of the condition,” according to a review of Family caregiving and congestive heart failure written by Gerard J. Molloy, Derek W. Johnston, and Miles D. Witham.

However, caregiving can often cause frustration and emotional distress for family members and friends of an individual living with heart failure. Yet this is something you don’t often hear about. We spoke with three caregivers across Canada to hear their perspectives of supporting a loved one with heart failure.


Erin Cherban – Caregiver her husband

Erin Cherban’s husband has dilated cardiomyopathy and she notes how it all began nine years ago when he was experiencing shortness of breath, stomach pain, and tiredness. Their older son was one-year-old at the time, and she had just returned to work from maternity leave.

During their first appointment, Erin and her husband were told that he was only expected to live two years unless he got a heart transplant (which they were told was next to impossible). Thankfully, after changing to another cardiologist, the couple discovered that the initial diagnosis was not the only path forward.

Erin explains how the heart failure journey has changed their relationship. “Initially, for me, the biggest hurdle was trying to come to terms with potentially being a widow with a young child before I had even turned 40. It’s frustrating to feel helpless both for your partner and yourself.”

“It took us a few years to learn how to cope with the changes as he had to slow down and look after his health. Meanwhile, I panicked and looked for a new position that would give me the ability to financially support my entire family if necessary. After emerging through ‘survival mode’ as a couple, I think the experience made us much closer.”

 Nevertheless, Erin explains that there are elements of heart failure support which could be improved. “The support around heart failure is primarily geared toward elderly people. It’s an odd experience trying to juggle child-care needs with medical appointments and work.”

“I know ‘patient navigators’ are becoming popular in hospitals back East, I think this would help in BC. I’m lucky that I work at St. Paul’s Hospital and have a good understanding of our healthcare system, but at times I had difficulty comprehending what we were being told at appointments and then understanding the long-term impact for my husband and our family. It would be helpful to have someone – a navigator/social worker/peer mentor – to talk with at times.”

Erin stresses that it’s important not to fall into a cycle of feeling hopeless. “Each individual person’s journey is different, and we are lucky to live in an era with new advances. You need to take the journey one day at a time and not worry about the future, just concentrate on navigating the present. Make sure you create opportunities for fun and laughter for both of you and your family. Accept help when you need it from any source,” Erin added.

Lyndall McCormack - Caregiver to her husband

“I am a caregiver to Rick, my husband of 36 years,” said Lyndall McCormack. In late 2010, Rick’s congestive heart failure was diagnosed in the ER of St. Paul’s Hospital, although he had been treated by a cardiologist for five years prior to this.

“Many of the doctors had given up on Rick, with one suggesting he get his affairs in order as there was nothing more they could do. It was a chance meeting with Dr. Toma who actually gave us hope by listening to our story and wondering out loud why the transplant team wasn’t notified. He put us on a more positive path.”

Lyndall describes Rick’s heart failure diagnosis as frightening for both of them. “We were both scared of the chance of stroke more than anything during the surgery. With all this uncertainty we were on a roller coaster of emotion but our relationship was pretty much strong and intact.”

After surgery, Rick’s body didn’t respond well and he spent three months in the cardiac ward.  Several times before and after the surgery, Rick had four incidences of ‘code blue’. Lyndall told us how she even observed him ‘die’ and called for help. “Mercifully he was saved but the aftermath of these incidences was that his larynx was injured which resulted him being put a liquid diet and developed sepsis in the heart incision.”

“It was a time where I learned to adopt a ‘whatever’ attitude in respond to feeling so powerless.” Lyndall relayed how her life became one of hospital visitations, consultation/advocacy with the doctors, reporting Rick’s condition to family and friends, work, sleeping, and eating.

 She found that waiting in the hospital for doctors to inform them of Rick’s condition was very frustrating as they often didn’t appear at the expected time. “Often Rick’s memory of what was said by the doctor was fuzzy probably because of the medication he was on and I felt left out of the loop at those times. Also, I found it particularly frustrating not to be included in the doctors’ rounds discussion with Rick.” Today, she feels that a parking concession for caregivers at hospitals would be helpful and lower stress.

“Being both a spouse and caregiver can get crazy because sometimes it’s not very clear which ‘hat’ you’re wearing at any one time. The patient is dealing with their own mortality, pain and fears and can be demanding waving you off because you are trying to help them (too much in their view), or demanding care and attention, such as dressing changes.”

 “Their personality can change, and you may not be able to see the person you married. Our relationship was chaotic and confusing but like with any storm I held on to the aphorism that ‘this too shall pass’. For me, it was not until he [Rick] had recovered from his heart transplant that I began to see the person I married again. Luckily it didn’t take me too long before I fell back in love with him again,” Lyndall concluded.


Anonymous – Caregiver to her husband of 35 years

The final caregiver we spoke to wishes to remain anonymous. *Mrs. Bloggs’ husband suffered a heart attack during a trip away in November 2017.

“Unfortunately, his symptoms did not present themselves as typical heart attack and he thought he had food poisoning – as a result, we didn’t seek medical attention until the next day. By that time, his heart muscle had been damaged. He received two stents in the US and an additional four more back in Canada. Even though we were told he had heart damage in November, we did not fully understand what heart failure meant until a nurse from the cardiac clinic explained it to us in late December,” she said.

In terms of the affect that heart failure has on their relationship, Mrs. Bloggs notes that there is sometimes an added element of sadness that wasn’t there before. “I feel his pain when he can’t easily do the things he used to be able to do like walk up a hill/stair or help family.”

Due to fluid/sodium restrictions, the couple don’t eat out as often, nor are they as spontaneous when it comes to socializing with people, especially with physical activities. “We have found that our plans need to be flexible as some days are better than others. More than anything else, I am profoundly thankful and grateful that he is still here.”

As a caregiver, Mrs. Bloggs finds it frustrating to be the ‘police’ in their relationship – reminding her husband about sodium/fluid/dietary restrictions and asking him to be mindful of how much he takes. “I hate being a ‘nag’ and sometimes decide I’m not going to be but then I see he deteriorates and so I go back to reminding him. I totally understand when he’s so sick and tired of seeing doctor after doctor, and it’s difficult for me to try and maintain a light and positive attitude in order to coax him into a better mood.”

“If there was a system of direct advocacy that could ease the load, that would make things easier.  By that, I mean if there was someone who could evaluate how he is doing on a weekly/bi-weekly basis and help with making recommendations/appointments.”

“I personally don’t like the term caregiver because I don’t feel like that is what I am.  My husband can take care of himself, but I am his support person, emotionally more than anything else. I sometimes need to be supported but can’t ask because this makes him feel bad. It’s difficult but rewarding to learn to treasure every moment and live fully in every moment.”


The name *Mrs. Bloggs was used solely for the purpose of this article.