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Nick Hartshorne-Evans

Pumping Marvellous Foundation

This feature has been made possible through funding from CSL Vifor UK. Pumping Marvellous Foundation and Media Planet have written the article and CSL Vifor have reviewed the contents in line with the requirements of the ABPI Code of Practice (November 2022, Job Number UK-NP-2200086).

It’s important to know the signs and symptoms of heart failure and understand your risk of developing it because it is treatable. Just remember B.E.A.T. — Breathless, Exhausted, Ankle swelling, Time to see your GP or practice nurse.


In 2010, Nick Hartshorne-Evans was diagnosed with heart failure. At the time, he was just 39 years old. “I was in such a state because I’d had symptoms for six weeks,” he remembers. “My whole body was shutting down, so when I was told what the issue was — I felt relieved, quite honestly. It was only after I left the hospital three weeks later that it sunk in, and I started to think: What is going to happen to me?”

Living with heart failure

Heart failure means that your heart isn’t pumping as it should. It is either not pumping enough blood around the body or is not filling with blood properly. It doesn’t mean that your heart is about to stop, but it is undoubtedly serious and can lead to pump failure.

Yet, Nick is proof that with the right treatment and management, people with the condition can still live fulfilling lives. His experience even prompted him to become the founder of the UK’s only dedicated, patient-led heart failure charity — the Pumping Marvellous Foundation — where he is now the CEO.

“Heart failure is treatable,” he says. “You might not find it easy at the start — or even later because good management requires effort. But my message is that you can live with it. In fact, I know of some people in the heart failure community who have been living with it for 25 years.”

Around 50% of heart failure patients deal
with a double burden because they can
also be affected by iron deficiency.

Focusing on the risks and symptoms of heart failure

Nick notes that heart attack and cardiac arrest get more coverage in the media whereas “heart failure has become their sort of distant relative.” That has to change, he insists, because it’s estimated that around 1 million people in the UK are affected by heart failure. It can happen to anyone at any age, although it’s mainly prevalent in older age groups.

There is a range of causes, but risk factors include hypertension; a previous heart attack that has damaged your heart; a disease of the heart muscle or heart valve; type 2 diabetes; or a viral infection that affects the heart (for example, Nick’s condition was caused by the swine flu virus).

Symptoms can include breathlessness after minimum exertion, fatigue and — in many, but not all, cases — swollen ankles and/or swollen legs and tummy and unexpected weight gain. If you are concerned, Nick’s advice is to see a GP as quickly as possible. “It’s important to catch heart failure early as there are some very good treatments available that can help manage the condition,” says Nick.

The link between heart failure and iron deficiency

Unfortunately, around 50% of heart failure patients deal with a double burden because they can also be affected by iron deficiency (a topic to explore on Iron Deficiency Day every 26 November).

“This means they are having to manage heart failure symptoms and iron deficiency symptoms,” explains Nick. “Their GP may prescribe them iron tablets, but they may also need a specialist to administer intravenous iron therapy. I know people with heart failure who have been treated this way, and they feel much better afterwards.”

Ultimately, the key to living with heart failure is effective self-management. “Know how to identify the signs and symptoms, and know what to do if they get worse,” adds Nick. “Take your medication, improve your mobility and have a balanced diet. Make sure you have a good health team — and, above all, try to live your life. Don’t let heart failure rule it.”

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