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Cardiologist survives heart attack

As one of New Zealand's top cardiologists and researchers, Rob Doughty seemed like the least likely candidate for a heart attack.

It seemed like just another workday morning as Rob walked across a quiet courtyard towards Auckland Hospital.

Ahead lay a busy schedule of appointments in the clinic with patients suffering from heart disease.

One of New Zealand’s most experienced cardiologists and a leading academic teaching at the Auckland School of Medicine, Rob is also the Heart Foundation’s Chair of Heart Health and sits on the charity’s Scientific Advisory Group.

Rob knows as much about the heart as anyone; he’s spent more than half his life working to stop people dying prematurely of heart disease.

But at 8am on Wednesday 22 April last year, it was Rob’s life that was in danger.

“I was literally between Auckland Hospital and the School of Medicine – the two places that I work – when I started getting pains in my chest. Then it came on pretty badly, with pain down my left arm and feeling sick. I started feeling faint so I sat down on a bench.”

Reading the signs

Rob knew how to recognise heart attack symptoms, but it took him a few minutes to recognise what was happening inside his body.

“It was quite a confusing time. Because I’d been sick recently and had been coughing a lot, I tried to rationalise it as being part of that. But when all the symptoms set in, I knew I was in trouble, that it could be a heart attack and I had to get help.”

The courtyard was unusually empty, but luckily Rob was so close to the hospital that he could walk himself straight into the emergency department.

“I could have been anywhere else; I could have been biking in some forest or been up a mountain, but I was sitting between the two medical institutions I work in having a heart attack. In retrospect, the irony of that hasn’t been lost on me."

The medical staff, who are Rob’s colleagues and close friends, were stunned.

“In terms of who was likely to have a heart attack, I was not high on that list. It caused quite a shock for many people.”

Tests revealed that Rob’s right coronary artery was completely blocked and the best way to restore normal blood flow was to insert a stent.

Treating a friend

Working in the catheter laboratory (where ‘dye tests’ or angiograms are performed) that day was Dr Jim Stewart, an interventional cardiologist from Green Lane Cardiovascular Service, who described Rob as being in pain, but alert and aware of his diagnosis. 

After identifying Rob’s blocked artery, Dr Stewart set about restoring blood flow to the heart muscle by passing a fine wire through the blockage, then using a suction device to remove the blood clot.

He then inserted a stent to treat the narrowing in Rob’s artery.

“Once blood flow was restored in the artery, Rob’s pain began to recede and his heart function improved.”

Dr Stewart has been performing that procedure for many years, and he’s well aware of the potential risks if things go wrong. 

“That awareness is obviously somewhat heightened when you are treating someone who is a friend and a colleague, so my personal level of stress was probably a bit higher when treating Rob than it would be if I were treating a member of the general public,” he says.  

“Nevertheless, I tried to just do what I always do in those situations, and fortunately it worked, as it usually does!”

Disbelief and shock

As Rob’s two teenage daughters, his partner and friends rushed to be at his side, there was a collective sense of disbelief. 

“Everyone that came into my room said ‘I can’t believe this is happening to you’. I’ve been physically active all my life, I’ve tried to lead a healthy life to my best ability. I’ve not smoked, not been particularly overweight, I don’t have diabetes or high blood pressure and my cholesterol has been ok,” he says.

“For a 51-year-old male, I was in the lowest part of the risk charts. But we know that risk is never zero and I’ve proved that myself.” 

Rob describes the ordeal as incredibly humbling and sobering.

“Here I was experiencing what I’d dealt with for many, many years. And while in medicine we always attempt to understand how a patient feels, you can never truly understand that until you’ve experienced it yourself.” 

Slow road to recovery

After a day in hospital, Rob was sent home to begin a long period of recovery. 

It was a challenging time and he now knows just how much a heart attack can affect a person’s confidence. 

“I took several weeks off work. I was extremely well supported in the weeks after, but my confidence took a real hit. You take a knock physically because even though you’re treated very quickly you’re exhausted afterwards. But it also knocks your confidence,” he explains. 

“Not to be melodramatic but circumstances for me could have been very different and I spent a lot of time processing those kinds of thoughts. We really mustn’t underestimate what people go through in those weeks after a heart attack.” 

To give himself the best chance of returning to normal life, Rob followed all the advice he would normally give to a patient. He went through a 12-week exercise rehabilitation programme and made a number of important life changes.

“I’ve always tried to eat healthily but I’ve fine-tuned that. I pay much more attention to what I eat. I’ve tried to balance the stress of a busy working life with trying to maintain a healthy pattern of living through that. I’ve had to readjust to taking tablets on a regular basis and that was new to me."

A nagging question

It’s now been a year since his heart attack and Rob’s recent heart check-ups have been positive.

But one thing nags at him; he still doesn’t know why he had a heart attack.

“I know I’ve obviously got underlying coronary disease and that’s what caused the heart attack. But what was the trigger that made it happen on that day?” he asks.

Dr Stewart says Rob’s case illustrates there is a lot we still don’t understand about heart disease generally, and the risk of heart attacks in particular.

“He is a young, fit man with a healthy lifestyle, so, statistically, he should not be at high risk of a heart attack. However, while we don’t see cases like Rob’s every day, he is, sadly, not all that unusual.”

Rob says the only way to find answers is through continued research.

“It’s been a very salient personal reminder that there’s a hell of a lot more still to do. I would love to be able to understand why this has happened and yet I can’t answer that, despite all I know about the heart.

“Research holds the key to answering the many questions we still have. To have the greatest impact on improving heart health for New Zealanders we must invest in this research now and in the future.”

Now a survivor himself, Rob is more passionate than ever about the need for Kiwis to recognise heart attack symptoms and take action.

“Even if you appear to be low-risk and think you’re bullet-proof, well you’re not.”

Thanks to the support of generous people like you, the Heart Foundation is New Zealand’s leading independent funder of heart research. Since 1970, we have invested more than $57 million into ground-breaking research and training for cardiologists, including Professor Rob Doughty.

Please help fund more vital research into heart disease so that we can better prevent, treat and cure heart disease.