Stigma 2: Intelligence and Heart Disease

The deep connection between the heart and brain is documented in academic studies and romantic poetry dating back to ancient times. For example, being "heartsick" and "broken-hearted" can have real impacts on someone's physical and emotional well-being, two sides of the same coin.

The connection between the heart and brain is more delicate in people with Congenital Heart Disease (CHD), and Adult Congenital Heart Disease (ACHD) makes cardiac disturbance, leading to potential oxygen deprivation extra noticeable to those with the conditions. According to the book, Asthma: Comorbidities, Coexisting Conditions, and a Differential Diagnosis by Richard F. Lockley and Dennis K Ledford, "Asthma is one of the most common associated conditions in children with Congenital Heart Disease." As I have both asthma and ACHD, I can attest to its impact.

From requiring a daily inhaler and an additional, stronger one when I am ill and have extra difficulty breathing, through personal experience, I know how difficult, it is not only to breathe, but to speak and, most importantly, think. However, this is part of why this topic is particularly painful to discuss.

The stereotype that people with cardiac problems could have lower intelligence is based on some reality. Blood flow delivers oxygen to the brain, and when that is impaired by a malfunction of the heart, the result is either temporary or continually impeding cognitive function. That is why people with CHD or ACHD often, but not always, experience "shorter attention span, impulsiveness and problems with social interactions" along with impaired executive function, according to the Adult Congenital Heart Association's article, "Neurocognitive Issues in Congenital Heart Disease." From my personal experience and observations throughout my life, I can agree that this is not merely a stereotype or a stigma. Rather, the potential for permanently or temporarily impeded cognitive function due to a cardiac issue is a harsh reality.

However, as I said, it is a "potential" reality. It may impact some more than others, but, for many, it is a very real experience. The stereotype, one could say, is where the harm comes in. Growing up, when people heard about my heart disease, they would turn to me and speak slower, assuming I could not keep up. Or my classmates who were considered "normal" would get angry at me and be threatened by my having the correct answers despite my health issues. As a current Master's student, looking back and considering how I achieved this level of higher education, it was directly linked to the management of my heart disease and asthma to bring balance to my life, I am glad to have proven that stereotype generally wrong.

I say "generally" because the stereotype is partially correct. When my asthma acts up, or I am near a magnetic field, and my pacemaker is impacted, I do not think clearly. It is like a horse running in slow motion barely able to touch the ground. I sound and look weak. My thoughts and movements are slow and my breathing labored as I try to stay alert and focused. I am cognitively impaired in those moments. Only when I can reestablish balance via an inhaler or moving away from what caused it, do I return to normal.

It is a frightening experience, but thanks to modern medicine, I can generally avoid temporary cognitive impairment as long as I avoid the cause. Thus, as I have said before, I can only achieve what I have thanks to the balance that I maintain as diligently as possible.

There are stereotypes, although not always correct, are often based on a grain of truth. But it is not how such stereotypes are correct; it is the stigma they carry and the fire they inspire to overcome it.

Growing up being treated as less cognitively capable than my peers was my breaking point. It is the primary reason I make such an effort in every aspect of my life to achieve some semblance of normality. This leads me to strive for excellence in whatever way I can.

Instances of oxygen deprivation are some of the most unsettling and confusing times of my life. However, while it likely can never be prevented, nurturing the delicate connection between heart and brain via maintenance of asthma and cardiac health allows me to better maintain the balance. Thus, I urge others with this condition to attempt to do the same to the best of their ability, as it will help in lessening the stigma of both CHD and ACHD from passing to others with this condition.

Reference List:

Adult Congenital Heart Association (n.d.). Neurocognitive Issues in Congenital Heart Disease. [online] ACHA. Available at: https://www.achaheart.org/your-heart/educational-qas/living-with-chd/neurocognitive-issues-in-congenital-heart-disease/#:~:text=These%20include%20shorter%20attention%20span [Accessed 25 Jul. 2024].

Lockey, R.F., Ledford, D.K. and World Allergy Organization (2014). Asthma : comorbidities, coexisting conditions, and differential diagnosis. Oxford ; New York: Oxford University Press.