Almost Two Years Later… Here’s Where My Heart Is Now

I figured it was time for another SCAD update.

It’s now July, and I’m approaching two years since my Spontaneous Coronary Artery Dissection (SCAD). In many ways, life has slowly been returning to normal - but this year has been a reminder that recovery isn’t always a straight line.

Back in January, I was feeling amazing. Through February and March my fitness continued to improve, recovery from exercise was better than it had been in a long time, and for the first time since my SCAD I genuinely felt like I was getting me back.

I started setting bigger goals again. I was trail running, regularly climbing Mt Kaukau, and had set myself the challenge of climbing it 100 times this year. Each time I went a little further on the trails giving me a little more confidence that my body was capable of more than I’d dared believe after my heart attack.

In April I completed a 12km trail run event. I absolutely loved it. I finished feeling strong, healthy and incredibly grateful. It felt like a real milestone.

Then, two days later, everything changed.

I was in the studio, finishing a session with a client when I started to feel… “heart attack-y”. It’s hard to describe unless you’ve been there, but I knew the feeling was different enough that when I returned to the house, I said to my husband - who, thankfully, was working from home - “I think we should go to A & E.”

Because of my history, I was seen almost immediately. ECGs, monitors, blood tests… the whole routine = a lot of waiting.

Then the blood results came back... My troponin levels were elevated.

Instead of heading home, I found myself admitted to hospital for the next few days while I underwent more tests, scans and investigations to work out what had happened. I was immediately put back on beta blockers - despite my many protestations about them - blood thinners continued and anticoagulants were added, and I remained under constant monitoring.

While I waited for answers, my mind went into overdrive. Had I pushed my heart too hard with the trail run? Had I finally found the limit? Was this somehow my fault? Then there was the MHT. I’d only recently started Menopause Hormone Therapy after a lot of thought and discussion. Could the increase in hormones have triggered something? Every question I asked the Doctors and Nurses was met with a fairly firm “No.”

It wasn’t until I was handed my discharge papers that I was finally told what they believed had happened. It didn’t appear to be another SCAD, but imaging had shown what was described as a bruise indicating there had been some damage to the heart.

The advice? “Rest up for the weekend and return to normal on Monday.” After spending three and a half days in hospital, it all felt surprisingly matter-of-fact.

Roll forward a couple of months, and at my follow-up Cardiology appointment, I finally got a little more clarity. The recommendation was a definite no to continuing Menopause Hormone Therapy. Given my history, they felt the potential risk outweighed the benefits. It was also a definite yes to staying on beta blockers. Thankfully, they switched me from bisoprolol to metoprolol, and for me the difference has been enormous. The constant fog has lifted, I have more energy, and I finally feel like I can function again. They also confirmed that they consider the April event to have been another heart attack based on the markers (troponin levels continued to increase) and the evidence of bruising.

I still don’t think that’s fully sunk in.

It’s hard to reconcile "heart attack” with how I actually felt. In my mind, heart attacks are dramatic, life-changing events. Yet just a few days later, I was back walking up the hill.

If anything, it highlights that heart attacks aren’t always what we imagine them to be. Some are far more subtle than people realise, particularly when you’ve become very attuned to your body. Had I ignored that feeling because it “wasn’t that bad,” the outcome may have been very different.

If I’m honest, the last few months have knocked me sideways.

The beta blockers absolutely flattened me. It felt like I was living under a weighted blanket. Everything was muted - my energy, my motivation, even my enjoyment of things. Life felt dim, and I was barely functioning. I’d have the odd good day where I’d get my steps in or manage a run, only to spend the next few days paying for it with overwhelming fatigue. Somewhere along the way, I gave up on myself a little.

I’d set all these goals: lift weights consistently, hit my daily step target, run on the flat, tackle the hills, keep ticking off my Mt Kaukau climbs… and, in what now feels like a moment of complete optimism, I’d even signed up for a triathlon, somehow expecting I’d fit cycling and swimming into the mix too.

The reality is very different.

Just getting through a full day of clients often took everything I had. Once I finished, there wasn’t much left in the tank, and all those goals quietly slipped away. Add in a Wellington winter - cold, dark, windy, wet and relentlessly uninviting - and the couch became a very convincing place to be.

With my medication change a couple of weeks ago (from bisoprolol to metoprolol), I’ve already noticed a difference. The fog is lifting, my energy is slowly returning, and I finally feel like I’m coming up for air.

Now comes the hard part. Finding my rhythm again.

I’d love to say you simply flick a switch and get back into the habits that once felt effortless, but it doesn’t work like that. Fitness fades. Confidence fades. Routines disappear. Rebuilding them takes time, and it’s proving harder than I expected - especially when Wellington keeps serving up sideways rain.

But I’m starting to feel like myself again.

And right now, that’s enough.