"After my second heart attack I decided to completely change my life"

After Javed Hussain, from London, had his first heart attack in 2016, he thought his life was over. However, his second heart attack gave him a new lease on life.  

In 2016, Javed had started eating well and taking more care with his health. He joined a gym and decided to do a session before work, where he runs a successful advertising agency specialising in multicultural communications. “When I got into the gym, I suddenly felt that I shouldn’t touch heavy weights because I didn’t feel right. I got into the shower and my head was spinning,” recalls Javed. 
Afterwards, Javed went into the office, where colleagues immediately recognised something was wrong and encouraged him to call 999. When paramedics arrived, they did an echocardiogram (ECG) which came back normal. “They asked me what I do for work, so I told them I run this advertising agency – they thought I was having a panic attack and told me to relax.” 

Javed remembers hoping that it was just a panic attack, however, he’d started to feel a pain growing in his chest. He insisted to the paramedics that something was wrong, telling them that his mother and father both had heart attacks, and his brother also recently had a stent fitted. “By the time I was in the ambulance, I was asking them to give me some medication because the pain was just too much. They realised the attack was probably happening now, so they blue-lighted me straight to hospital and I was operated on that day,” remembers Javed. 

Later, in 2018, Javed was going through a very stressful time in his life – he was getting divorced and had moved in with a friend. On a very hot day in July, he started to feel as though his head was spinning again. “I called 111 and said I was feeling similar to when I had my first heart attack. They sent medics who did my ECG, and again everything was normal. I walked down to the ambulance!” However, it was only after a troponin blood test was done later in hospital that Javed discovered he had, in fact, experienced another heart attack. 

Interestingly, this second heart attack kick-started a mind-set change for Javed. “After my first heart attack, I thought my life was going to finish. I thought I should sell my business and look into retiring,” says Javed. “My second heart attack was completely different. I couldn’t be a victim anymore. There was nobody there to look after me and wash my clothes. I had to take care of myself. So, I decided to completely change my thinking, change my wardrobe, change my life. I now make sure I exercise, eat well, and – most importantly – stay positive.” 

Javed recently got remarried at the age of 60 and now credits his second heart attack for shifting his perspective. “You have one beautiful life, you need to live it.”

Heart attack diagnosis 

Electrocardiograms (ECGs) are an important tool for identifying heart attacks, however – as Javed’s story illustrates – they are not always able to provide a definitive diagnosis. An ECG takes a snapshot of the heart's electrical activity at a specific point in time. However, during a heart attack, changes to this activity can be transient and may come and go. Furthermore, not all heart attacks present in the same way. Some patients may have atypical symptoms or ECG patterns that do not conform to the normal diagnostic criteria. 

A troponin blood test is a more accurate way of identifying if someone has had a heart attack. Troponin is a protein released into the bloodstream when heart muscle cells are damaged. Elevated levels of troponin means there has been damage to the heart muscle, such as during a heart attack. However, there is no one-size-fits-all approach to how much troponin needs to be in the blood to indicate a heart attack has occurred.

“There was a point where we used a single diagnostic threshold for both men and women. In a very simple study, we were able to show that using sex-specific criteria would increase the recognition of heart disease in women – addressing one of the long-standing biases in cardiac care. But of course, it’s not as simple as just sex,” explains BHF researcher Professor Nick Mills. His team at the University of Edinburgh are aiming to improve the speed and accuracy of heart attack diagnosis by harnessing the power of artificial intelligence (AI) to provide personalised care. 

“Personalised medicine is actually pretty simple. It’s getting the right treatment to the right person and understanding how they’re going to respond to that treatment by taking into consideration their circumstance,” Professor Mills explains.

Using data from 10,038 patients in Scotland who arrived in hospital with a suspected heart attack, an algorithm called CoDE-ACS was developed. It uses routinely collected patient information, such as age, sex, ECG findings and medical history, as well as troponin levels, to predict the probability that an individual has had a heart attack.

When tested on 10,286 patients in six countries around the world, CoDE-ACS was able to rule out a heart attack with 99.6 per cent accuracy, and performed well regardless of age, sex, or pre-existing health conditions – showing its potential for reducing misdiagnosis and inequalities in cardiac care. 

“I’ve come to the conclusion that all diagnostic thresholds are wrong, because they’re not personalised. We try to apply criteria that are derived from the average person to an individual person, and this really doesn’t work. There is an opportunity for personalised medicine to provide equal care for everyone.”

Do you want to hear more from Javed Hussain and Professor Nick Mills? 

Watch our Live & Ticking event here