When Christine Handford last saw her 31-year-old son Kade, he was fit and bursting with pride about how he was looking and feeling.
"The last time I had lunch with him, he had the stomach [he said he wanted], 'Look at this Mum, I'm doing very well'," she said.
But a week later, the relatively healthy Toowoomba man returned home from the gym and died unexpectedly from a heart attack.
Despite the efforts of three ambulance crews, the six-foot-four larrikin who loved to give big hugs, died in hospital in the southern Queensland city on July 25, 2021.
The coroner later found Kade Handford died after a build-up of plaque in his arteries.
He was one of the 17,331 Australians to die from coronary heart disease in 2021.
Of the 160,000 Australians who were hospitalised for coronary heart disease that year, 16,000 — or 10 per cent — were aged between 15 and 44.
For many people, the disease has no warning signs and the diagnosis is unexpected.
But Mrs Handford said that in hindsight, Kade did show some symptoms, however, due to his age, no one thought anything of them.
"He was a little bit tired at times, short of breath after he had done a session at the gym," she said.
"I met up with him one day … and he said he'd had a bit of a headache with the peripheral vision disturbance.
"But being a young person, he just brushed it off."
Battle against complacency
The Heart Foundation says it has been a constant battle to get young people to take their heart health seriously and seek check-ups if anything feels a bit strange.
"We know all the seeds are there in people in their younger times," the foundation's chief medical advisor, Professor Gary Jennings, said.
"But there is a tendency to think you're invulnerable and immortal until something happens to someone around you."
Relatively young, high-profile people including cricketer Shane Warne, Senator Kimberley Kitching and Lisa-Marie Presley have died in the past year of heart-related conditions.
Professor Jennings said coverage of high-profile deaths had led to "record numbers" of heart health checks, but that momentum had been short-lived.
Data from Services Australia showed more than 17,650 checks were done nationally in November 2022, but that's now dropped back to 12,092 in January 2023.
The checks have been subsidised by Medicare since April 2019. Between then and January this year, 9 per cent of the 424,000 checks performed nationally were for people aged between 15 and 44.
The Medicare subsidy is due to end this year and the Heart Foundation has urged the federal government to make it permanent.
A heart health check is performed during a 20-minute GP consultation to assess the patient's risk of a heart attack or stroke.
It is recommended for Aboriginal and Torres Strait Islanders aged over 30 or for those in the general population aged over 40. The cost is determined by the GP.
Professor Jennings said it was important for people to have check-ups when they became eligible, and for them to follow advice for a healthy lifestyle.
For Christine Handford, there's been some comfort from her son's death, with many of those who knew him booking themselves in for heart check-ups.
"I've had quite a few people contact me and say thank you for making us aware of what to look out for," she said.
"Otherwise, they might have just brushed it off again. So, if in doubt, get yourself checked out."
Calls for checks after COVID
The Heart Foundation has also asked the federal government for heart health checks to be made available to everyone who has had a COVID-19 infection or is living with long COVID.
The foundation said COVID-19 infection worsened pre-existing heart conditions and also increased the risk of developing more than 20 heart conditions including heart attack, blood clots, heart failure and stroke.
University of Queensland and Frazer Institute researcher Dr Arutha Kulasinghe last year led a study, published in the journal Immunology, which found COVID-19 damaged DNA in cardiac tissue.
He said it was a concern to see healthy and young people develop cardiac complications after being infected with COVID-19.
"It's almost a canary in the coal mine," Dr Kulasinghe said.
"We are seeing that there are increasing complications that haven't been seen before in previous pandemics, such as the flu."
He said researchers were now looking at how to identify patients likely to develop cardiac complications earlier in life after contracting COVID-19.
