With a packed social calendar that included swimming, fencing, Judo and rifle shooting, 75‑year‑old Carol Eastley was fitter than her years.
She was also a full‑time carer for her husband, who had cancer, lung disease and was recovering from a broken hip, leaving little time to worry about her own health.
But when she collapsed during her sewing club, she knew something was wrong.
‘I’d set up the sewing machine when all of a sudden I felt really faint,’ says Carol, now 82, from Exmouth in Devon.
‘I can’t describe it – the feeling kept getting stronger, so I put my head between my legs to try and bring myself round. That’s the last thing I remember.’
While she’d had ‘funny turns’ before – a pounding in her chest, feeling light‑headed – these usually passed after she sat down for a moment. This time was different. When she finally came round, she was lying on the floor with paramedics around her.
‘That’s when I realised something was seriously wrong,’ says Carol.
She was taken to hospital but, after tests failed to find anything wrong, she was discharged without answers.
Over the next few months, this pattern of collapsing and being taken to hospital happened four times. Multiple trips to her GP left her with different explanations – perhaps anxiety, perhaps stress from doing too much – but no firm answers.
Carol Eastley, pictured with her late husband Richard, was diagnosed with aortic heart valve disease, a condition where the valve between the main pumping chamber – the left ventricle – and the body’s main artery fails to work properly
The 82-year-old was very active and enjoyed taking part in sports before her diagnosis
Eventually, she was referred to cardiology, where she was finally given a diagnosis.
Her symptoms were caused by aortic heart valve disease, a condition where the valve between the main pumping chamber – the left ventricle – and the body’s main artery fails to work properly.
Heart valve disease affects an estimated 1.5million patients aged 65 and over in the UK, with cases projected to double by 2040 as the population ages.
It becomes more common with age because natural wear and tear can stiffen or damage the valves.
Left untreated, the condition forces the heart to work harder to pump blood around the body and, in severe cases, can ultimately lead to heart failure.
Many patients with mild disease have no symptoms and may not need treatment. But as it progresses, it can cause breathlessness, chest pain, extreme tiredness, dizziness, swollen ankles and palpitations.
Experts believe the condition is significantly underdiagnosed, with research suggesting as many as a million over-65s in the UK could be living with heart valve disease without knowing it.
Those with severe heart valve disease often need a minimally invasive procedure to replace a narrowed aortic valve without traditional open-heart surgery, called transcatheter aortic valve implantation (TAVI).
It is typically performed using a local anaesthetic and involves a thin tube called a catheter being inserted into an artery, usually in the groin.
The catheter is guided through the blood vessels up to the heart and a replacement valve is compressed and pushed through the tube.
The new valve expands, pushing the old one’s leaflets aside and anchoring securely inside it.
The average waiting time for a heart valve procedure like TAVI on the NHS is 142 days, with research showing that 400 to 800 people die on these waiting lists every year.
While most patients leave the hospital within one to two days, doctors discovered Carol had more problems with her heart
She needed two urgent coronary bypasses, an ablation to correct her heart rhythm and a clip fitted to reduce her risk of stroke and spent nine days in hospital.
Coming home was the start of a long recovery.
Carol, pictured with her late husband, was told she needed a major operation to swap a damaged heart valve for a new one
‘I was on a frame, I felt dreadful and I was being sick all the time because of the antibiotics,’ she says.
‘For the first four months I could barely manage basic things like washing and dressing.’
It took around four months for Carol to get back on her feet and another six months before she felt able to properly care for her husband again.
Will Woan, executive director of Heart Valve Voice, stresses that aortic valve disease is highly treatable – but far too many patients are being misdiagnosed and delayed.
To get a diagnosis, patients suffering from classic symptoms need to be examined by a GP, who will use a stethoscope to listen for an abnormal heartbeat.
They would then refer the patient for a hospital echocardiogram, a scan to see how well their heart is working.
But, according to Mr Woan, many patients who present with symptoms are not immediately examined properly by a GP.
‘It’s very frustrating when we hear from patients who tell us the GP dismissed their symptoms as asthma, anxiety, even menopause,’ he says.
‘Typically, patients are being missed. They’re revolving around the system, becoming a burden to the NHS, then finally getting their treatment. Once you get to your cardiologist, your life can be completely turned around because it’s such a treatable disease.
‘The most recent NHS pathways have stipulated that treatment for these patients should be within 60 to 70 days – between eight and ten weeks – but the reality is patients wait more than double that time. Every week, every month that we miss can lead to complications, longer stays in hospital, and not as good an outcome.’
Four years after her operation, Carol can drive, shop and manage everyday tasks, although she still gets tired easily and has had to give up swimming and her old sports
Dr Jonathan Byrne, a leading interventional cardiologist who specialises in the treatment of coronary artery disease, says: ‘Heart valve disease is very common. It tends to occur as people get into their fifth and sixth decade, and the symptoms are often underestimated or misjudged by the patient.
‘Breathlessness, a reduction in exercise tolerance and struggling to do things on a daily basis is a slow, progressive problem, and often it’s ignored – particularly in women, who have a habit of just getting on with things.
‘Women in particular present a bit later because they put their symptoms down to other things, or they’re brushed aside by medical professionals.
‘Valvular heart disease is a very straightforward condition to treat if you catch it early, in a similar way to early cancers, which are easier to treat and have high cure rates.
‘If you present late, you’re more likely to present as an emergency – and then your outcomes are worse. That’s why detection, education and early treatment are so important.’
Four years after her operation, and after losing her husband in 2024, Carol continues to drive, shop and manage everyday tasks, although she still gets tired easily and has had to give up swimming and her old sports.
Looking back, she believes the problem lies less with individual doctors and more with the way the system treats older women with heart symptoms.
‘The doctors themselves were very good – I don’t blame them,’ she says. ‘It’s the system that’s wrong.
‘So much of cardiology is based on men – men’s bodies, men’s symptoms.
‘Women can have very different signs when their heart is in trouble, and we don’t always get picked up as quickly.
‘If my valve problems had been picked up and treated when I was 75, within the 10 weeks the guidelines recommend, it would have saved the NHS a fortune in ambulance journeys, hospital stays and carers – and it would have spared us a lot of worry.’
An NHS spokesman said: ‘We know there are some patients with heart valve disease who are waiting too long to get the care they need. Delayed diagnosis is an issue that affects women in particular, and we are determined to address this.
‘Our recently published plan for cardiovascular disease sets out how we will cut premature deaths from heart disease and stroke by a quarter within a decade, through targeted action to find those most at risk and to offer them the right support before a silent health problem turns into a potentially life-threatening emergency.
‘The NHS is also supporting local areas to roll out new rapid access valve assessment clinics, which have been shown to substantially speed up diagnosis and treatment.
‘But, if you have any concerns or you are experiencing symptoms, such as new breathlessness, dizziness or fainting, please contact your GP team as soon as possible or call 999 in an emergency.’
For further information, visit: heartvalvevoice.com
