A fit, healthy semi-pro rugby player in his late 30s, Paul was told his symptoms couldn't be a heart attack

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I was young, fit and healthy – a semi-pro rugby player for the past 18 years. My SCAD came out of the blue – I no prior chest pain, good blood pressure etc. A few weeks prior I had taken a blow off the ball to the ribcage and still had a slightly deviated rib, just over my heart. Being an older front-row rugby player, the body always hurts but once my SCAD was diagnosed, I did wonder if impact trauma damage might have been a contributing factor. 

I was also in the process of changing jobs and juggling work and semi-pro rugby and family life with two children, so all round it was quite a stressful time.

Events on the day

December 2019 – we had a tough game but nothing untoward. After the game I felt “Something’s not quite right” I was nauseous and breathless/lightheaded. Was this typical ‘rugby pain?’ – I thought I had popped a disc in my back, it felt like I had a spear from back to front...  Then the pain moved to my left shoulder and up into my neck. I started to panic. I thought “Panic attack…? Never had one before” but I knew my father-in-law had had one and been rushed to hospital because people thought it was a heart attack.

I managed to calm down my breathing. Didn’t get a huge amount of sympathy from my family because I always hurt after rugby. But I had a nagging feeling that something was not right. Tried to foam-roll my back because I thought I had hurt it playing rugby.

Tried calling 111 but couldn’t get though. Went online and put in my symptoms. It said to go straight to A&E. As I live in a remote area, I didn’t think an ambulance would find the house so at 10.30pm my wife said “Enough’s enough – I don’t want to wake up tomorrow next to a cold body…” So my father-in-law came to be with the children and my wife drove me to A&E. It was Saturday night and I was in A&E with ‘Oldham’s finest’… 

When I got to hospital

A canula was put in and bloods were taken. There was a queue for an ECG, so I was given GTN, which nearly made me collapse because my BP plummeted. I felt a ‘burning raw feeling’. At 4am I wanted to go home but a nurse said I was next to be seen. When the doctor came he said “I don’t want to alarm you but we’re taking you to resus” – my troponin blood test results were in.

I was asked (many times) had I taken heroin? Cocaine? The doctor said “You’re young, fit and healthy – absolutely no way it’s a heart attack. I think it’s pericarditis – have you been unwell?” Myocarditis was another possibility he was considering.

I was given orimorph for the pain and my memories are hazy after that… The GTN driver made my BP slump. I thought I was dying but actually it was ‘just’ my BP plummeting due to the GTN drip – this was very scary. 

The doctors on duty were concerned for me, but then a big road traffic accident came in and attention turned elsewhere. 

There was ST elevation on my ECG and my troponins were raised but the doctor couldn’t work out why (I didn’t fit in the box he’d put me in). The doctor whatsapped my ECG and troponin results to a senior doctor who asked for lots of tests. The renewed troponin test result came back at nearly 3000. Something was definitely wrong as troponins would have stayed at the 300-ish level if it was pericarditis. 

I was then transferred via blue light to Withenshaw hospital for an angiogram. The paramedics who took me had just come on shift. It was a very surreal experience. They didn’t make me feel concerned at all, there was lots of mundane chat – it was only later on that I realised this had been done on purpose to distract me. They did a great job allaying my fears.

In spite of my high troponin levels, after the angiogram my diagnosis was pericarditis and I was taken off all heart meds… I was discharged on Sunday with an MRI organised as follow up. The following Wednesday I was called in for my cardiac MRI. It was the week before Christmas. There was a large Tesco next to the hospital, so while I had my MRI my wife did the Christmas shop… 

I was told “You can’t leave, we’ve found a clot on the MRI, you’ve definitely had a heart attack. You’re going back to the cardiac ward… you can’t walk, you have to go in wheelchair…”  I still had a sense of rawness in my chest but otherwise felt OK.

They wanted me to stay in hospital for anti-coagulation treatment via a canula. It was 21 December and would have taken 4-5 days to complete. My wife and I didn’t like the idea of that at all so we were told that there was another way to proceed and I was put on a different medication which meant I could go home. When the doctors looked at the angiogram they found the heart attack in the apex (the tip – at the bottom) of the heart, in the Left Anterior Descending artery. It was too small to stent so I would be treated just with medication. 

Lessons learned

  • SCAD can happen to anyone
  • Need to recognise the storm brewing and intervene (self-help or seek help), I was ‘blow torching the candle and both ends’ at the time!
  • Younger, fit, healthy people don't always realise that their body is not indestructible and perhaps that is their risk factor?
  • It's better to go and get checked out than convince yourself it’s something else, go with your gut instinct 

Update (October 2023)

I’m approaching my fourth SCADiversary. If I had written this about 3 months ago, my perspective would have been entirely different.

I’ve recently had a bit of a setback after 3.5 years of getting back to nearly normal. I am still waiting to find out if there is a link between my current health situation and the previous SCAD. While this new period of ill health felt really awful, I also felt different this time. This was not my first rodeo! Laid in a hospital bed waiting for a scan, a quick message to Sarah from Beat SCAD and I have an email contact for Dr Adlam to share with the medical team. I can’t put into words how this alleviated the stress and worry, knowing I had an expert that understands me! I am forever grateful to Dr Adlam and the Beat SCAD team.

After my SCAD I gave up playing rugby on medical advice. I was given the chance to get back involved in a coaching role in 2021 and initially I thought it would help but it didn’t, it was probably the first time I really missed the sport and not necessarily for the rugby but more for the supportive network that a team and club provides.

Paul and family

It was a bit off and on at the start but persistence and support from mates in the game means I am now back enjoying the sport and waking up relatively pain free on a Sunday morning – which is a bonus!

Life keeps moving and it hasn’t always been kind, I’ve lost loved ones recently and at times it has been immensely hard. I’ve also had some brilliant times, finally going back to Canada 34 years after I last left the country as a 4-year-old and welcoming a new son, George, in March 2023.

In the run-up to my SCAD I had suffered with a period of poor mental health. If my SCAD has taught me nothing else, it is to be more in tune with my mental health. It remains one of the worst and best things that happened to me in that respect.

At the time of my SCAD, I had just handed in my notice to join another business that provided progression in my career. After having 12 weeks off I remember going in on the first day, everyone assuming I had spent the 12 weeks working my notice. I didn’t want to tell anyone the real reason, only my line manager knew. Must be something about men and not wanting to talk about things!

It took me nearly a year to build up the confidence to share with a senior colleague about my SCAD, quickly having to follow up that with an “I’m fine to be at work”!

It has definitely taken time, but I am now far more confident sharing about my condition at work and have begun to talk about my SCAD to more people. In December 2023, a week away from my 4th anniversary, I will be delivering a talk at a Safety conference in Canada where my SCAD experience will form part of the presentation.

I’m positive about the years ahead, I turn 40 in November 2023 and I am determined to get at least another 40 years!