Seeking life-changing solutions
Trudy Hall. supplied
In sudden cardiac arrest, every minute that passes before the heart is restarted counts. When the brain is deprived of oxygen for more than four to six minutes, the risk of irreparable damage increases exponentially.
That’s why, after Mary Armour suffered a cardiac arrest four years ago, her daughters were told, “There’s a chance your mom will wake up and not know who you are.”
Armour counts herself fortunate. First responders were quick to arrive, and after she was taken to the University of Ottawa Heart Institute, her care team enrolled her in a study where her body was cooled to preserve brain function.
“It made a big difference because when I came out of it, I hadn’t suffered any cognitive loss,” explains Armour. Since her heart event was attributed to “an electrical malfunction,” she now takes medication that regulates her blood pressure and keeps her heart from beating too fast. She also has a micro defibrillator, an electronic device to continuously monitor and help regulate potentially life-threatening electrical problems with the heart.
The experience inspired Armour to participate in BHRIITE, a research collaboration led by Dr. Peter Liu at the University of Ottawa Heart Institute. “I think about my daughters and potential genetic influences that could put them at risk,” she says. “So I’m happy to contribute to a better understanding of the heart-brain connection.”
Remembering a particular sequence of events from a decade ago still gives Peter Chaban chills. Yet he is also grateful for the insights he gained – and for the path that brought him to participate in UNEARTH CVD, a new research collaboration probing the connection between heart and brain health.
Ten years ago, on a day when Chaban got up early to tackle the dishes, he saw hot water run over a glass and his hand – and wondered why he didn’t feel it burn. “Within a moment, I fell to the floor, paralyzed,” he says. “But I was still able to call my wife’s name. She came running and called 911.”
Chaban had experienced a transient ischemic attack (TIA), a type of stroke that leaves no permanent impairment, and a subsequent MRI revealed a history of small vascular bleeds called silent strokes.
Learning that silent strokes are common in older age groups – and that TIAs are often followed by full-blown strokes – Chaban committed to healthy lifestyle changes. “I exercised more. I became more careful with my diet. I also tried to reduce my stress level.”
He is now keen to bring his insights to UNEARTH CVD, where his neurologist Dr. Gustavo Saposnik, St. Michael’s Hospital, is a principal investigator. “Since TIAs, strokes and heart attacks have implications for an individual’s brain function, I started to wonder whether there could be certain signals, such as difficulty with memory or a shorter attention span, that can give us advance warning,” says Chaban, “like thunder in the distance.”
Trudy Hall was walking her five- and seven-year-old daughters to school with her four-month-old in tow, when she suddenly fainted.
Aged 38 at the time and very athletic, Hall was incredulous when she woke up in the ICU and learned she’d suffered a cardiac arrest. “I couldn’t believe that I had needed to be resuscitated,” she says.
A diagnosis of idiopathic heart failure started a journey to look for answers. And a decline in heart function led her to receive a heart transplant six years later, a life-saving intervention Hall compares to “winning the lottery.” She now participates in the UNEARTH CVD study, led by Dr. Douglas Lee, Ted Rogers Centre for Heart Research at the Peter Munk Cardiac Centre, UHN.
“There is definitely a need for this kind of research,” says Hall, adding that as a nurse, she is trained to look at the whole person instead of focusing on conditions associated with single organs.
“Patients with heart conditions and their families are all concerned about potential issues affecting other parts of their bodies, and especially cognitive impairment,” she says. “I certainly remember times when I wasn’t feeling 100 per cent, and this did affect my cognition and my emotions. It affected my ability to manage things.
“We need to look at the person as a whole. Not only are our hearts and brains connected – they are having a big impact on our physical, psychological, emotional and spiritual well-being.”
To view this report on The Globe's website, visit globeandmail.com
To view the full report as it appeared in The Globe's print edition: Heart-Brain Connection