There were many different results on this hand. South probably opened 1NT at most tables. West clearly has a problem and I suspect the bids made were 2H, 3H, 4H, double and pass.. At one table, where West passed, the bidding was:-

  

  S      W        N       E

1NT    P        2C       P

2D      P        3NT     P

P       Dble     5C      P

P        P

  

This was allowed to make, because the signal for a spade return, after a heart and heart ruff, was misinterpreted.

  

West's double of 3NT changed a 65% score (+400 for 4 off) into a bottom ( -600). The double seemed reasonable because the bidding had shown N/S had a 4-3 fit in spades, at best, and retreat  to a minor seemed unlikely.

   

5C can go 2 off on a spade lead.

  

A heart lead is however more likely. When Declarer (North) ruffs the heart return, East knows that West was aware he could over-ruff, since West must have been able to see 13 hearts. Hence West's lead must indicate the suit he wishes to have returned - spades.

   

I would have chosen the HK to return, but the card chosen by East was the H8, which I think now is a lot cleverer than the HK. The H8, after Declarer has shown out, makes it clear that West knows East can ruff, and also lulls Declarer into thinking East has a high heart, so he can ruff low.

  

East can also count West for a void in spades, because Declarer, having only a single heart, must have 4 spades to justify his 2C bid. So the spade distribution is 4-6-3-0. It would be unreasonable for Declarer to ruff the second heart high, since a heart return from West seems, to Declarer, almost automatic.