An unexpected end to a swim

“The right side of my mouth was a bit numb,” recalls Adrian. When he went for a coffee after his training, Adrian realised the extent of his numbness. “I couldn’t drink, and I couldn’t feel the coffee,” he says. “It was like I’d been to the dentist.”

Becoming concerned, he called 111 for advice. The GP who triaged him over the phone didn’t seem too worried and didn’t think it was a stroke, and as Adrian was due to go on holiday the next day, he decided to book an appointment for his return two weeks later. There, he received a diagnosis that came as a huge surprise – Adrian had suffered a transient ischemic attack (TIA). A TIA, sometimes called a ‘mini stroke’, is when the blood supply to a part of the brain is temporarily blocked. TIAs have the same symptoms as a stroke, but they aren’t permanent and last less than 24 hours.

TIAs can be caused by a blood clot travelling to the brain from somewhere else in the body, usually the heart or major blood vessels. To get to the bottom of where the blood clot came from, Adrian had an MRI brain scan, which revealed he’d had two small strokes. Adrian was seen by a cardiologist and advised just to take a blood thinner in the long-term. 

“I wasn’t okay with that,” said Adrian. “So, I decided to pursue a second opinion.” Using his private medical insurance, Adrian came to HCA UK.

Discovering a hidden problem

His first appointment was with Dr Sam Firoozi, Consultant Interventional Cardiologist at The Harley Street Clinic. After a range of cardiac tests, Dr Firoozi told Adrian that he had atrial fibrillation (AF), a condition that causes an irregular heartbeat. Ensuring Adrian would receive the best care he could get, Mr Firoozi referred Adrian to his colleague Dr Oliver Segal, Consultant Electrophysiologist at The Harley Street Clinic, and an expert in managing AF. 

A bubble scan with Dr Segal detected another problem – Adrian had a patent foramen ovale (PFO), a hole between the left and right atria of the heart which is present from birth. A PFO can increase the risk of a stroke as it enables blood clots to travel from the right atrium to the left atrium, and then to the brain. This PFO was likely the cause of Adrian’s TIAs he experienced after swimming. Closing Adrian’s PFO with a device would reduce his risk of another stroke, but it would also make treating his AF more difficult.

A recovery that’s going swimmingly

Treating both of Adrian’s cardiac conditions would therefore require close collaboration between the two consultants. First, Dr Segal would perform a catheter ablation in Adrian’s heart, correcting the irregular heartbeat. Then, Dr Firoozi would close the PFO to prevent future strokes. Accessing the part of the heart where AF comes from is much harder, if not impossible, after a PFO is closed. As such, Adrian would first have an ablation, followed by monitoring his heart afterwards.

In March 2024, Adrian went in for his ablation with Dr Segal. When Dr Segal reviewed him in September, Adrian remained free of AF and Dr Segal recommended screening him for coronary artery disease with a CT scan. Surprisingly, despite being a non-smoker and an ex-elite athlete, the scan picked up that Adrian had a significantly diseased heart, and Dr Segal referred Adrian back to Dr Firoozi for further treatment.

“Dr Firoozi could see that one of my main arteries was too small,” Adrian recalls. “He thought I had coronary heart disease as well.” To address this, Dr Firoozi would also perform an angioplasty as well as the PFO closure. This is where a stent is inserted into a narrowed blood vessel to widen it and improve the blood flow. The PFO closure then involves inserting a mesh umbrella to close the hole in the middle of the heart. In just over six months, Adrian had an AF ablation, a stent inserted and a PFO closure. Recovering remarkably quickly, he could soon get back to his active lifestyle. 

“Dr Firoozi told me I was in decent shape so could just crack on,” says Adrian. “I was wanting to get back to the gym, rowing machine and swimming, and he told me to go for it.”

In between his two cardiac procedures, Adrian had a routine mole check that picked up a basal carcinoma on his cheek, which was luckily detected at an early stage and removed without further complications. He also noticed a few hip issues, so came to HCA UK for a hip replacement, which he is now recovering from. “I feel fit and strong and I’m now off the crutches, and I feel ready for the next phase of my life.”

Looking back on a life of sport

With his health worries now addressed, Adrian’s experiences have made him contemplate whether his PFO had affected him throughout his life. “As a swimmer, we knew a lot about my lungs when I was competing. I had bronchitis when I was a kid, so my lung capacity was huge but my VO2 max was very bad. 

“Looking back on my career, maybe that was because I was dealing with an undetected hole in my heart. There were times when I was racing that I didn’t quite feel like I was getting the most out of myself,” recalls Adrian. “I was competing at a high level for 10 to 12 years, and there were probably only three times where I felt like I’d nailed my time when swimming.”

Adrian’s experience has also made him appreciate the importance of being proactive with your health. As a former elite athlete with an impressive corporate career, Adrian was fit and used to pressure, and previous check-ups hadn’t detected any problems. “I used to think I was invincible,” he says. It was the in-depth tests and scans that had that picked up the PFO, not the usual exercise ECGs he’d had before. Cardiac problems are also something Adrian’s been noticing more and more in professional athletes around his age. “I’ve got a mate who’s an Olympic rower and he needed an ablation,” he says. “If you’re putting your body under so much, what’s the cost?” 

But no matter your lifestyle, be that professional athlete or not, Adrian is keen to share what he’s learned with others. “I’ve got loads of mates my age, and I’m telling them all to get a heart check,” he says. “When men reach a certain age, they’re particularly at risk of heart attack or stroke. If there’s anything my friends can do to prevent being caught out, they should do it.”  

To find out more about our cardiac services, visit our cardiac care hub, or call our dedicated cardiac referral line on 020 7616 4988.