43rd Parliament, 1st Session

L064B - Thu 6 Apr 2023 / Jeu 6 avr 2023



Thursday 6 April 2023 Jeudi 6 avril 2023

Private Members’ Public Business

Heart Valve Disease Awareness Act, 2023 / Loi de 2023 sur la sensibilisation à la cardiopathie valvulaire


Report continued from volume A.


Private Members’ Public Business

Heart Valve Disease Awareness Act, 2023 / Loi de 2023 sur la sensibilisation à la cardiopathie valvulaire

Mr. Cuzzetto moved second reading of the following bill:

Bill 66, An Act to proclaim Heart Valve Disease Awareness Day and Heart Valve Disease Awareness Week / Projet de loi 66, Loi proclamant la Journée de sensibilisation à la cardiopathie valvulaire et la Semaine de sensibilisation à la cardiopathie valvulaire.

The Deputy Speaker (Ms. Donna Skelly): Pursuant to standing order 100, the member has 12 minutes for his presentation.

Mr. Rudy Cuzzetto: I’m proud to rise today to present Bill 66, the Heart Valve Disease Awareness Act.

At least one in 40 Ontarians are living with heart valve disease, and the number is higher for seniors, reaching at least one in eight Ontarians over the age of 75. Across the country, over a million Canadians are living with heart valve disease. Given our aging population, the number of Ontarians with heart valve disease is expected to double by 2040, and triple by 2060.

Cardiologists have described this as “the next epidemic of heart disease,” affecting millions of people around the world. Patients with heart valve disease are too often undiagnosed or under-diagnosed, and untreated or under-treated. Far too often, they’re not referred for care until it’s too late.

When it’s not treated early, heart valve disease can lead to heart failure or death. The one-year survival rate for the most serious forms of heart valve disease is as low as 50%. This also puts more stress on our hospitals, with more hospitalization for heart issues that are completely preventable, because heart valve disease is a very treatable condition, especially when it’s detected early with a simple stethoscope, which was invented over 200 years ago by a French doctor, René Laënnec. Any GP can use a stethoscope to listen to your heart for murmurs and other sounds that can indicate heart valve disease. If they hear anything unusual, they can refer you to a cardiologist for more tests.

When it’s detected early, heart valve repairs and replacements can significantly improve the length and quality of life. For patients with heart valve disease, it allows them to return to an active role in the community, back to work—or being the MPP of their riding—and caring for their families.

Unfortunately, heart valve disease isn’t well known and isn’t well understood by the public. Based on a recent Heart Hub survey, only about 3% of Canadians over 60 are aware of or concerned about the most common types of heart valve disease. They’re concerned about cancer, heart attacks, strokes, Alzheimer’s and many other conditions, but not heart valve disease.

It worries me to hear that only about a quarter of adult Canadians over 25 had a stethoscope check within the past year, and this fell to about 19% during COVID, which was the lowest in Canada. About half of Canadians say their GP rarely or never checks their heart with a stethoscope. On top of this, Canadian women are much less likely to get a stethoscope check than Canadian men.

Speaker, considering the risks of valve disease and the burden we know it causes in our hospitals, we can and we should be doing much better. In France today, for example, over three quarters of visits to a GP include a stethoscope check. That’s why, last year, the Canadian Cardiovascular Society set up a heart valve disease strategy working group, led by our friend, Dr. David Messika-Zeitoun, an expert in heart valve disease at the University of Ottawa Heart Institute. I want to thank him again for joining us here at Queen’s Park for our reception on February 22, which was Heart Valve Disease Awareness Day, along with Dr. Janine Eckstein, who flew in from Saskatchewan to give stethoscope checks to MPPs and staff. Organizations like this work at the top of their game to help us prevent these types of diseases from occurring.

Dr. Michelle Graham, a professor of medicine at the University of Alberta and president of the Canadian Cardiovascular Society, said, “I applaud Bill 66, and I hope all provinces and territories do the same. I see patients every day who live with this condition. How will an awareness day help them get better? It won’t, really. But there are things that we can do that can be life-changing and reduce some of the pressure on the health system. Raising awareness of heart valve disease, promoting detection through regular and simple stethoscope checks, and identifying problems through regular check-ups are things we can do.”

Regular screening is especially critical for Ontarians at a higher risk, including those over the age of 60, those with a family history of heart valve disease and those with high blood pressure, high cholesterol, diabetes, or other risk factors for heart disease. People living with heart valve disease often have very different symptoms, and it’s easy to dismiss them as normal signs of aging.

In my case, Speaker, my family doctor, Dr. Farkas, diagnosed me with a heart murmur early, when I was 18. I’ve spoken about Dr. Farkas before; he came to Canada after the Hungarian revolution in 1956, and his office is now my constit office today. He recommended a follow-up test, but I was young and I felt healthy. Shortly afterwards, my father died of lung cancer from asbestosis, on December 12, 1985. So I went on with my life, without the test.

I went to work at Ford Motor Co. in Oakville. I never had energy; I was short of breath. At the time, I thought it was because of my 10 hours or 12 hours of work, but my wife Marie knew it was something else. So I had another physical, with Dr. Linda Sabetti, including a simple stethoscope check, and when the doctor listened to my heart, she heard a murmur. She referred me to Dr. Fountas, a cardiologist in Toronto. Other tests confirmed that my bicuspid aortic valve had to be replaced.

Next, I had to choose between a pig valve, which would have to be replaced after 10 to 15 years, or a mechanical valve, which is designed to last a lifetime but requires you to take a blood thinner, Coumadin, every day for the rest of your life to reduce the risk of blood clotting. I was fortunate to have my neighbour who was the sales representative for heart valves, so I ended up choosing the mechanical valve, which I had done 14 years ago, in 2009. I had the surgery just across the street at the Peter Munk Cardiac Centre. I was fortunate to have Dr. Christopher Feindel, who was one of the top cardiac surgeons in the world, nicknamed “God” by hospital staff in 2015.

When Dr. Feindel came out of surgery—I was not there, but I was told—he went into the waiting room where my family and my mother were sitting. My mother was 81. She spoke very few words of English. He went right over to her, and she grabbed his hands, and in Italian she said, “Mani di Dio.” I’ll translate that: “God’s hands.” She didn’t know his nickname was God.

When Ronald Reagan went into surgery, he said to the doctors, “I hope you’re a Republican.” When I went into surgeries, all I could remember saying to Dr. Feindel was, “Remember, I have two young boys.”

I understand that Dr. Feindel is looking forward to retirement, and I want to wish him all the very best, because today I’m living a normal, healthy life because of him.

I see my cardiologist every year and I have an angiogram to check that my mechanical valve is in good working order. Actually, I will be having an appointment on Thursday to do that.

At this point, I also want to thank Trinh Luong from Edwards Lifesciences in Mississauga for visiting my office a couple of weeks ago. She told me that today’s heart valves can be replaced or repaired with minimally invasive surgery. New valves can be inserted through an artery, with just a small incision in the groin. So you don’t have to go through the five-hour operation, like I did.

Speaker, I also want to take a moment to thank Ellen Ross, the managing director of Heart Valve Voice Canada, for all her support with our reception and the drafting of Bill 66. She’s out of the country, so she wasn’t able to be here today, but I’d like to read a short statement from her: “Bill 66 will bolster Heart Valve Voice Canada’s mission to raise awareness about heart valve disease. With Ontario’s population growing older, the burden of heart valve disease is on the rise and early detection can save lives.” I agree with her totally.

In closing, again, I want to encourage all members to have a stethoscope check—and, please, encourage your constituents to go get a stethoscope check.

Listen to your heart. It saved my life; it could save yours.

I look forward to working together with all members in this House to continually bring awareness to Heart Valve Disease Awareness Day and to Heart Valve Disease Awareness Week.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

Mr. Tom Rakocevic: I want to thank the member from Mississauga–Lakeshore for bringing this to the attention of everybody and for talking about a health issue and spreading awareness on it. I think it is absolutely imperative.

When it comes to the day and age that we live in, I think we’re very blessed because we truly live in an age of medical miracles. And I say that because a dear friend of mine’s son, many, many years ago, just after birth, had to undergo heart surgery—imagine, a baby, just after being born. I can’t even imagine the stress, as a mother, that she went through. I can tell you that he’s an adult now. He plays soccer. He does all the things that anybody else does. It is absolutely a miracle. He is blessed to have been born in this time and here, where he had access to the medicine and the treatment that he did.

I know that it can’t be easy—you were so composed talking about your own health, talking about your own doctor. That can’t be easy, and it is absolutely brave. I think what you’re doing is so important, because so many among us don’t really think about our health.

When I look at the seniors’ groups in my community, so many of them go to exercise clubs—it’s mostly the women; the men, not so much. I think we all need a little kick in the pants to regularly go to the doctor. If we know a loved one, we should be encouraging them with all of our heart—to tell them to continue to look after their health and go see a doctor when they’re not well, because it could be absolutely life-saving.

So I thank the member opposite for sharing his own personal medical history. It’s not easy. You are encouraging others to be open about their own health and to take their health very seriously.

I, for one, am so happy that you had such a great doctor doing the surgery that you had and that you are here among us today.

To all of you: Get your health checked. It’s so important.

Thank you, again, to the member for raising this. This is absolutely important. We have to do everything we can to encourage people to watch their health, and we should be bringing forward more legislation to get people to think about their own health. It is absolutely important. Thank you for doing that.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?


Mr. Andrew Dowie: I’d like to give sincere thanks to the member from Humber River–Black Creek for his very eloquent comments on this.

I’m delighted to rise today in support of Bill 66, the Heart Valve Disease Awareness Act.

Truly, heart health is far too often an afterthought. We don’t see our heart. We take it for granted. Sometimes members of the public question whether we even have one—but it really is there.

That’s why it’s incredible to see this bill from the member for Mississauga–Lakeshore. He took one of the most difficult experiences in his life and made something positive of it.

If your heart valve were blocked or not working well, how would you know? Nobody knows you better than you, but how do you really know what your heart is telling you? What it really means is, to keep your health, you must get checked. Your body may be moments away from being stopped from working.

Bill 66 proposes to proclaim February 22 as Heart Valve Disease Awareness Day and to proclaim the second full week of September as Heart Valve Disease Awareness Week.

We often need this brief reminder that cardiac wellness is serious business—because sometimes that reminder hits a bit too close to home.

For six years back home, my seatmate—first, on the committee of adjustment for the town of Tecumseh and subsequently on the Tecumseh town council—was Mike Rohrer. Mike was a well-known personality here at Queen’s Park. During the Harris government years, he was Windsor’s eyes and ears as a staff member, and he served as a two-time candidate for MPP. We lost Mike, at the young age of 44, through a cardiac event, and his was a sobering loss and a reminder that our own cardiac health might be changing without our knowledge.

I would also like to acknowledge, back home, the incredible team at Hôtel-Dieu Grace Healthcare. Based on Mike’s situation and others in the community, and under the leadership of CEO Bill Marra, Hôtel-Dieu Grace Healthcare intends to establish the new Bob Probert cardiac wellness centre in my riding, at the Tecumseh Arena. It’s not there yet, but the plans are there. They actually have an existing location at the Petro Family Exercise Centre within the Dr. Fouad Tayfour Regional Rehabilitation Centre. It provides Windsorites with medical, educational, exercise, nutritional and psychosocial support for people with cardiac-related concerns. I look forward to supporting this initiative for my riding in any way that I can—so, undoubtedly, there’s no better mechanism for awareness than by support for Bill 66. While the Probert cardiac wellness centre is a longer-term realization, we can truly begin to take care of our cardiac health right now by creating awareness, as MPP Cuzzetto’s bill will undoubtedly do.

Will this bill work? Yes. Thanks to the member for Mississauga–Lakeshore, I actually took the opportunity to have my first physical in over five years just last week and to have my heart listened to, and I’m happy to report that all was good. But what would my future be if I had been carrying an issue for the last four years?

In closing, I encourage all members of the Ontario Legislature to support Bill 66, as I intend to do, and to bring awareness of and action on cardiac health forward for all Ontarians.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

Mr. John Vanthof: It is always an honour to be able to stand in this House and speak on the issue that is under debate, and especially so this afternoon—Bill 66, to make a heart valve awareness day and awareness week. I commend the member from Mississauga–Lakeshore for bringing it forward. One of the greatest things about this place is when members use their personal experiences to further the good of Ontarians, and I commend the member for bringing forward his personal experience. It’s one of the things I enjoy most about this House. The member and I have a great relationship—among many, one of my favourite members.

A member who I wish was here today speaking to this is our member from Niagara Falls. Unfortunately, he is under the weather today; many of us are. Hopefully, I’ll do his remarks justice. He also had a heart valve replaced, 12 years ago, and he sometimes jokes with us that that’s the reason he’s still kicking us where we don’t like to be kicked.

Anyway, both the member from Mississauga–Lakeshore and the member from Niagara Falls share that, and they both share their life experience, to try to tell the rest of Ontarians how important it is. If you recall, the member from Niagara Falls also brought forward a similar bill regarding PSA testing. It was asking for a test, and it didn’t pass—but it was the same sentiment: to try to help fellow Ontarians.

I commend the member. In his speech, he talked about the pressure in the health system and regular screenings, and I agree with everything that he said.

Private members’ bills—I try not to make them partisan; I don’t believe they should be. But we should also recognize the situation that we’re facing in Ontario right now. There are two million people in Ontario who don’t have access to a family physician, to primary care, so for those of us who do—I have access to doctors, and I don’t go often enough for physicals. But how hard is it for someone to go for a physical when they don’t have access to a physician? It’s not something that developed over the last term or the last—but it’s a fact. So raising awareness is very important—I commend the member—but we also have to raise awareness that, quite frankly, there are many people in this province who, even if they want a stethoscope check, don’t have access. I would be remiss if I didn’t raise that point—again, not in a partisan manner. But there is a trend that there is a cost to certain procedures, and again, that creates an increasing lack of access. I’m not going to belabour that point.

We support this bill. We support any awareness initiative that can prevent serious incapacity or fatality. But we all have to recognize the barriers that are there—the barriers that a bill like this is trying to help. Unless we remove those barriers, we are going to lose people from heart valve problems. We’re going to lose people because of those barriers.

Again, I really commend the member for bringing this forward, for bringing his personal—and I heard it in his remarks. For bringing his heart and soul to this issue, I commend him. We are going to support it, and I thank him very much for giving us the opportunity—speaker, thank you for giving me the opportunity to take a few minutes today.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

Ms. Natalie Pierre: I’m honoured to join my colleagues in the House today to speak about a very serious health issue that affects millions of people around the world: heart valve disease.

Heart valve disease is a condition in which one or more of the heart valves become damaged or diseased, causing the valves to become stiff, narrow or leaky. People with HVD experience different symptoms, including fatigue, shortness of breath, chest pain and congestion. Individuals at higher risk are those with a history of heart disease, high cholesterol, high blood pressure and diabetes. Without treatment, patients can suffer significant health problems, including reduced mobility, stroke, heart failure and, in severe cases, death.


Right now, there are more than one million Canadians living with heart valve disease. As the population of Ontario ages, instances of HVD are also increasing, causing cardiologists to sound the alarm, describing it as the next epidemic in heart disease.

Heart valve disease is serious and requires prompt medical attention.

Earlier this year, on February 22, my colleague MPP Cuzzetto hosted Heart Valve Voice Canada and the Canadian Cardiovascular Society here at Queen’s Park. Rudy shared his personal story and his experience living with heart valve disease. As he mentioned earlier, his doctor detected a murmur in his heart when he was 18, which is why everyone, no matter their age, should see their doctor to make sure their heart is healthy.

In my community of Burlington, Joseph Brant Hospital has recognized this trend and has established a heart function clinic.

Heart conditions, especially HVD, can be monitored and successfully treated when detected early, and many people living with HVD, like my friend MPP Cuzzetto, can live normal, healthy lives.

Speaker, Heart Valve Disease Awareness Day and Heart Valve Disease Awareness Week will raise awareness of HVD.

If you or someone you know is experiencing symptoms of heart valve disease, seek medical attention right away.

Heart health is crucial for Ontarians of all ages.

Thank you again, MPP Cuzzetto, for sharing your lived experience and for the opportunity to speak to Bill 66.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

MPP Jill Andrew: Today, I’m glad to stand in support of the government member’s motion addressing heart valve disease awareness.

Last year, I lost one of my closest friends to a heart condition. She worked in community services. She worked in long-term care. She was an education worker. She had done all kinds of jobs caring for her community. But she didn’t care for her heart as much as she should have. Her schedule also didn’t allow her the time that we may have as MPPs—or even those of us who were “people of influence” before becoming elected officials. Her doctor visits were pretty much confined to her work schedules and what she could squeeze in, when and how. She left behind kids—kids who are now motherless.

So I just want to say about this bill that, as the member for Timiskaming–Cochrane said eloquently, we will support any piece of legislation that seeks to raise awareness about health conditions; that seeks to raise awareness about the importance of seeing your doctor, seeing your health care providers when necessary.

But I really want to highlight that we need to create the conditions where workers, regardless of whether you’re a C-suite worker or whether you’re the person nickelling and diming it in your community, or whether you’re the person helping vulnerable community members, like my friend was, who didn’t have time, literally, in her day to take care of herself—we need to create the conditions to allow those folks to also get the type of health care that government members certainly get, and that every other elected official, I would say, in this country, in this province, in this city has access to. Because one life lost due to unfair circumstances is one life too many.

So I hope that bills like this will come up for many issues, whether it’s prostate cancer—which we saw wasn’t successful—whether it’s endometriosis, which we had some success with last year; whether it’s sickle cell; whether it’s gastrointestinal issues; whether it’s colon cancer—you name it.

We need to ensure that Ontario is a better and safer place. That means that folks need to have doctors. They need to have access to medical care professionals to take care of them.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

Ms. Donna Skelly: I am honoured to rise today to speak to this legislation proposed by my colleague and my friend the member from Mississauga–Lakeshore proclaiming Heart Valve Disease Awareness Day and Heart Valve Disease Awareness Week, which will bring attention to this very serious and potentially life-threatening disease.

About 13% of Ontarians over the age of 75 have HVD. Heart valve disease is diagnosed when one or more of the valves in your heart doesn’t work in that the valves don’t open or close properly. If a valve doesn’t open or close correctly, the blood flow through your heart to your body is disrupted. The most serious conditions can lead to debilitating health problems, including heart rhythm abnormalities, stroke, heart failure, blood clots, and even death. And with our aging population, the incidence of HVD is increasing.

The most common form of HVD is aortic stenosis, a reduction of blood flow due to a narrowing of the heart valve. If a severe case is left untreated, the mortality rate is as high as 50%.

However, the good news is, when detected early, HVD is very treatable, often with minimally invasive surgery. Heart valve repairs and replacements can significantly improve the length and quality of life for HVD patients. Ideally, diagnosing the condition early is the key to avoiding health complications.

One of the problems impeding early detection is the variability of HVD symptoms. Unfortunately, because HVD symptoms are so wide-ranging, they are often dismissed as normal signs of aging.

Increased public awareness and early detection are extremely important in treating this condition successfully. That is why it is so critical, so crucial to support an act to proclaim February 22 as Heart Valve Disease Awareness Day and to proclaim the second full week of September as Heart Valve Disease Awareness Week.

With Ontario’s aging population, the burden of heart valve disease is increasing, and early detection is the key to saving lives.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

Mr. Brian Saunderson: It’s a pleasure to rise in the House this afternoon to speak to the MPP for Mississauga–Lakeshore’s Bill 66 to have a heart valve disease day declared on February 22 of each year, just about a week after Valentine’s Day, and then the first week in September declared as Heart Valve Disease Awareness Week. Madam Speaker, this is clearly an issue that is very close to the MPP’s heart; in fact, it’s in his heart, so I want to thank him for sharing his story and bringing this to our attention in this House.

We’ve heard from the various speakers on both sides of the floor how critical it is that we get examined and get our hearts checked. I can say, representing a riding with 150,000 people where we have a slightly higher percentage of seniors in our population, this is a very critical issue for the residents of Simcoe–Grey, as for in fact all Ontarians and every member of this House.

I do want to compliment my colleague on sharing his story and putting his heart and soul into this motion today, as the member opposite said. I think that the testimonies we’ve heard about impacts for the various speakers—from people, in their lives, who have had issues with heart disease.

I, too, have a story and it involves myself. Despite the fact that I was an athlete and competed in two Olympics for our country by the age of 30 and continued to be active and healthy throughout my life, I got back from a cycling trip with my wife at the age of 51 and was diagnosed with a blockage and had to have a stent put in. After the stent was put in, I went through two other procedures because it was discovered that I had a severe arrhythmia and I had an episode where I did faint and go down. So now I have an intracoronary defibrillator that helps me and is there as a backup. I do live with heart disease. It is manageable. I have this as a backup. So if I ever show up in the House with curly hair or smoking ears, you’ll know that I had an episode.

These are things that are silent threats to each of us and to our residents—and to make sure that we have access to testing and care to identify these issues, and the incredible service and medical system that we have.

I can say that through the four heart procedures I had at the Southlake hospital in Newmarket, the staff were incredible, the physicians were incredible, and the level of care, I think, is probably second to none across Canada. It’s a testimony to our health system when we can spot these issues.

So we encourage everybody to raise awareness so that people seek out the diagnosis. It’s a very simple stethoscope test, and it can identify a crippling issue.

Thank you to the member. I support his bill.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Further debate?

The member has two minutes to reply.

Mr. Rudy Cuzzetto: Thank you to all my colleagues from Windsor–Tecumseh, Flamborough–Glanbrook, Burlington, Simcoe–Grey, Humber River–Black Creek, Timiskaming–Cochrane, Toronto–St. Paul’s—and I know the member from Niagara Falls is not here, but I know he would have wanted to be here to speak on this as well—for all your support and for all your thoughtful comments today.

I also would like to thank the Minister of Health and her team for their support.

I’d like to thank the office of legislative counsel for their assistance with this bill and everyone else who helped us along the way, particularly Ellen Ross and her team at Heart Valve Voice Canada and Michelle Graham from the Canadian Cardiovascular Society for all their help and their advocacy for these patients and their families.

I also would like to thank Dr. Linda Sabetti. I want to thank Dr. Peter Fountas and Dr. Christopher Feindel and the incredible team at the Peter Munk cardiovascular hospital.

I also want to thank Dr. Messika-Zeitoun from the University of Ottawa Heart Institute and Dr. Janine Eckstein from the University of Saskatchewan for flying here to Toronto for our reception earlier this year and helping raise awareness of heart valve disease.

And of course, I want to thank my staff, including my OLIP intern from the fall term, Alia Mufti, who helped with the research and drafting of this bill.

Lastly, Speaker, as we all return to our ridings next week, I just want to take a moment to wish everyone a blessed Good Friday, happy Easter, happy Passover, happy Vaisakhi and happy Ramadan Mubarak.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): The time provided for private members’ public business has expired.

Mr. Cuzzetto has moved second reading of Bill 66, An Act to proclaim Heart Valve Disease Awareness Day and Heart Valve Disease Awareness Week. Is it the pleasure of the House that the motion carry? Carried.

Second reading agreed to.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Pursuant to standing order 100, the bill is referred to the Committee of the Whole House.

Mr. Rudy Cuzzetto: I would like to refer this bill to the Standing Committee on Social Policy.

The Acting Speaker (Ms. Natalia Kusendova-Bashta): Is the majority in favour of this bill being referred to the Standing Committee on Social Policy? Agreed. The bill is referred to the Standing Committee on Social Policy.

All matters relating to private members’ public business having been completed, this House stands adjourned until Monday, April 17, 2023, at 10:15 a.m.

The House adjourned at 1614.