Paul Nolan was a fit 52-year-old who ran marathons, didn’t smoke, ate healthily and drank moderately.
Yet, on a cold December evening in 2022, he “dropped dead” when out training with his friends at Newbridge Athletics Club in Co Kildare. “I just dropped to the ground. I was clinically dead for three to four minutes. Some people who were running behind me thought I was messing, but they turned me over and someone said, “he’s gone f***ing blue.”
Fortunately, a social worker in the running club who had recently been recertified for cardiac pulmonary resuscitation (CPR) led the CPR and use of an on-site defibrillator. Paramedics arrived in an ambulance 10 minutes later and brought Nolan to Naas General Hospital.
Initially, the medical team thought Nolan had taken a drug overdose, even though he says he “has zero interest in drugs”. “I was put into an induced coma for 24 hours. They woke me up on Saturday evening and did tests to try to figure out what happened,” he explains.
An angiogram at the Blackrock Clinic was carried out the following Monday morning, which revealed Nolan had one artery (the left anterior descending artery – the heart’s biggest artery) almost completely blocked in two places. The next day, using angioplasty procedures (in which a balloon stretches open a blocked artery), he had three stents put in to improve his blood flow. He was released home from hospital the following Saturday. He went back to work part-time before Christmas but didn’t return full-time to the office until February 2023.
‘It’s therapeutic to talk about it. I feel a bit detached relaying a story I’ve heard about, because I don’t remember anything even though I’m the main protagonist’— Paul Nolan, on his heart attack
Now, one year after his heart attack, he’s keen to talk through his experience in the hope that he will encourage other active, fit men to have regular medical check-ups to see if, unbeknown to themselves, they are at risk of heart disease.
“It’s therapeutic to talk about it. I feel a bit detached relaying a story I’ve heard about, because I don’t remember anything even though I’m the main protagonist,” says Nolan who also contracted pneumonia and a self-healing hypoxic brain injury (due to restricted flow of oxygen to the brain) during his traumatic experience. “Only about 7 per cent of people survive an out-of-hospital cardiac arrest in Ireland so I’m a bit of an outlier,” says Nolan.
Incredibly, even though he had what is often described as a widow-maker heart attack (because it involved the heart’s biggest artery), he didn’t have any scarring on his heart. He will have to take cholesterol tablets, beta-blockers and blood thinning medication for the rest of his life.
It’s very common for individuals to experience depression in the weeks or months following a heart attack but Nolan says that hasn’t been his experience. “Before I was discharged from hospital, I was told that most cardiac patients end up with pretty severe depression. I’ve been dealing with episodic depression all my adult life but I haven’t had a depressive episode since this happened,” he explains.
He did, however, feel a mix of emotions in the immediate aftermath of his heart attack. “I felt very disorientated initially and had a horrible feeling like you have as a child when you’ve done something wrong – that this was all my fault. This feeling morphed into anger about different things and with people for different reasons. I felt like I’d looked after myself so well for so many years and yet found myself in this condition,” he explains.
Nolan says it was only when he talked to the cardiac physiotherapist did he think differently about his experience. “She said to me, ‘this was always going to happen to you and only that you are very fit, this would have happened five or 10 years ago and you would have had zero chance of survival’.”
Nolan feels incredibly grateful to his fellow runners at the Newbridge Athletics Club who started CPR so quickly. “The outpouring and support to me, my wife, Trish and our children has been amazing,” he says.
‘I feel great. I’m physically very well and my head is in a great place. Life is back to pre-Covid normal now only better’— Paul Nolan
His wife, Trish, is also a marathon runner and a regular running mate of Nolan’s since his recovery. “And I’ve often had the sense of not being in the right place, but, that night, I was exactly where I was meant to be,” he says in reference to having fast and effective support from his fellow runners.
The irony for Nolan – who is head of marketing at the Royal College of Surgeons of Ireland (RCSI) – is that in mid-November 2022, he had had a check-up with his GP who estimated that his risk of having a cardiac event in the next 10 years was about 4 per cent. “I had a follow-up appointment with an electrocardiogram and blood tests the day before I ‘dropped dead’, which found my cholesterol levels to be about 5.5 (the same as the year before), which pushed my risk up to about 8 per cent in the next 10 years. My doctor said my cholesterol was a little bit high for someone like me, fit and eating healthily, so he had decided to put me on a statin,” explains Nolan.
Adopted as a child, Nolan has limited information on his family history to help him work out his genetic risk of heart disease. Now back at work and back running, albeit at a slower pace (he walked and jogged the Dublin marathon last October and has signed up for next year), he is very keen to encourage men to get regular check-ups to catch cardiac problems before they become a medical emergency or worse still a fatal incident.
“I feel great. I’m physically very well and my head is in a great place. Life is back to pre-Covid normal now only better, so I want to promote guys taking an active role in their health and wellbeing,” says Nolan who also sings in a gospel choir and writes music and sings under the name Ilsantino.
Monitoring your heartbeat when doing intense exercise is one way of checking your health. “Nobody should exercise beyond 80 to 85 per cent of their maximum [heart] beats per minute, which is calculated by 220 minus your age, and I don’t think many people know this.”