Siobhán O’Connell was not too concerned when she experienced shortness of breath and noticed her ankles were swollen two years ago

At the request of her friends, she mentioned her symptoms to her doctor, who referred her to a cardiologist due to a history of heart disease in her family.

O’Connell (60) underwent tests at the Mater private hospital in Dublin. The results gave her the “shock of my life”.

“The angiogram said my heart muscle was failing. I just remember thinking: ‘What do I do now?’ I thought: ‘Oh Jesus’,” says the Dubliner.

She had “no pains or nothing”. The “good news”, she says, was that she did not need stents or a pacemaker and her condition could be treated with tablets. The experience forced her to become “more serious about what I was eating, alcohol and exercise as well”.

At the time of the tests in March 2024, her heart function was about 25 per cent, O’Connell says. She was informed about a year later that under 35 per cent puts a person at risk of sudden death.

“It’s probably as well I didn’t hear that in 2024 because I had enough going on,” she says. She learned that normal heart function is about 55 per cent. After interventions, her rate has reached 43 per cent, she adds.

“I feel very lucky that I dodged the heart attack somehow. But other people mightn’t. I thought I had swollen ankles and I was huffing and puffing. I didn’t realise how much help I needed in terms of my heart needing attention and looking after.”

Prof Mark Dayer, consultant cardiologist and clinical lead for heart failure at the Mater Private Network in Dublin, says heart failure is “more common” in men overall, with roughly twice as many men as women experiencing it.

But this changes at certain ages and when it comes to different types of heart failure, he says.

Dayer says men tend to have more heart attacks, angina and a condition called dilated cardiomyopathy, which he explains is a “big heart that doesn’t tend to pump very well”.

“In younger people, it tends to be men and it tends to be a heart that doesn’t pump well,” he says. Affected women tend to be older. “In the 75 to 85 bracket, it’s roughly equal between men and women. In the very elderly, 85 or older, numerically, women have more heart failure than men.”

Why is there an increase in heart failure among older women? Dayer says the reason is not clear, but they have conditions such as high blood pressure, obesity, valve disease or diabetes, among others.

“There are differences in hormones, physical attributes and size that make men more likely than women to have certain conditions and vice versa,” he says.

“There is no doubt that once women go through the menopause, they tend to catch up on men. Post-menopause, women really accelerate with getting coronary disease and other problems.”

Dayer also points to alcohol consumption countrywide, describing it as a “big cause of heart failure”.

Given the State’s ageing population, increasing obesity rates and low physical activity levels, says Dayer, the issue will become more pronounced in the coming years.

There is a need to focus on the differences between men and women regarding diagnosis and treatment.

Despite a history of heart disease in her family, O’Connell never thought it was something that would affect her.

“You look back and think: ‘Should I have known?’ But life is so busy, and heart failure didn’t cross my radar at all … I was thinking maybe the weight, but because I didn’t have any pains, I didn’t think the heart,” she adds.

Now, almost two years on, she has turned her life around. She attends exercise classes several times a week, walks when she can and has reduced alcohol.

To other women, she has one overriding piece of advice: “If in doubt, get it checked out.”