Having hit his mid-50s, former Olympic runner Roger Black thought the fact he sometimes nodded off in front of the TV in the early evening was ‘just a sign I was becoming an old git’.
Similarly, Roger, now 58, blamed ageing for the fact that over the past couple of years he would get so tired driving back from speaking engagements, he would pull into a service station for an energy-boosting cup of coffee ‘every half an hour or so’.
Now he wonders if it wasn’t ageing that was to blame for his tiredness, but instead his heart.
For in August last year, doctors told Roger he had severe heart-valve disease – where one of the four valves in the heart stops working as normal. Without an operation the outlook was bleak, not least because his aorta – the main blood vessel taking blood from the heart – was also damaged.
‘The doctors said I could be out on a jog one day and my aorta could burst and I would die – they didn’t quite put it like that, but that’s what they were saying,’ says Roger, who lives in Guildford, Surrey, with wife Jules, 57, a youth theatre director.
It is difficult news for anyone to process – but especially for Roger, who until this was going for daily 30-minute runs and looks as lean as he did as an athlete.
‘The thing is, I had felt fine – I didn’t have any symptoms apart from the tiredness,’ says Roger, who won silver in the 400m at the 1996 Olympics.
Yet Roger counts himself as one of the lucky ones. Doctors were alerted to his need for surgery after his faulty valve was detected aged 11 by a school nurse during a stethoscope check of his heart (as was routine at the time).
Roger thought his nodding off while watching TV was caused by ageing
The former Olympic runner instead discovered his heart was to blame
More than 1.5million live with heart-valve disease – although many are unaware of it
He has had annual checks since and knew his valve would one day need replacing. but he ‘didn’t expect it to be so soon’.
Many aren’t as fortunate – around 40,000 sufferers in the UK die every year from heart-valve disease, often due to heart failure (as the faulty valve means their heart needs to work much harder pumping blood).
More than 1.5million people live with the condition – many unaware of it, even though it can be easily detected via a one-minute check with a stethoscope.
Roger is backing a campaign by the charity Heart Valve Voice to improve awareness of the symptoms – breathlessness on mild exertion, light-headedness, feeling older than your age and weariness – and is urging any over-65s who experience them to ask their GP for a stethoscope check for heart-valve disease.
The most common form of heart-valve disease, aortic vein stenosis, is usually associated with ageing and is most common in the over 60s. It is often not preventable and may affect otherwise fit individuals (Mick Jagger was treated for it aged 75).
It occurs as the aortic valve – which sits between the aorta and the left ventricle, the main pumping chamber of the heart – becomes hardened or calcified (the result of blood clots combining with cholesterol around the valve, then hardening). This narrows the opening, reducing the flow of blood around the body.
As Dincer Aktuerk, a consultant cardiothoracic surgeon at St Bartholomew’s Hospital NHS Trust in London, explains: ‘A typical valve is 2.5cm wide, but in those with severe stenosis the blood may be pushing through an opening of 1cm or less.
‘That means your coronary arteries and heart don’t receive enough blood and you develop heart pain and breathlessness and other symptoms.’
Roger says he would not have been able to cope with the disease without the support of his wife, Jules (right)
Following his treatment, the 58-year-old is walking more every day
Roger has this and a rarer form, aortic valve regurgitation, which occurs when the aortic valve doesn’t close normally, so blood that should flow into the aorta instead leaks into the heart and lungs.
It most commonly occurs due to a defect present at birth – as in Roger’s case.
All forms of heart-valve disease are treatable if caught early, but left untreated can have a worse outcome than many cancers. Once symptoms occur, 50 per cent of patients risk dying within two years, says Mr Aktuerk.
‘The trouble is people tend to put the symptoms down to a drop in fitness, or to them just getting older,’ he adds.
‘But if you are breathless and get tired with minimal exertion – such as going up the stairs – or have unexplained chest pain, then you need to ask whether it could be heart-valve disease.’
He adds that symptoms do get mistaken for asthma or bronchitis.
A stethoscope check can detect the tell-tale murmur sound suggesting a heart-valve problem. Further checks include an echocardiogram – an ultrasound of the heart – to show the valve in more detail.
NHS backlogs can mean some wait a year after referral for an echocardiogram, ‘which, given there is 50 per cent risk of sudden death within two years when symptoms start, is not good,’ says Wil Woan, Heart Valve Voice’s executive director.
Treatment depends on age and the extent of the disease.
For regurgitation, medication such as diuretics may be offered to reduce the volume of blood.
Transcatheter aortic valve implantation (Tavi) – where a valve made of metal and animal tissue is threaded from an artery in the groin and positioned over the existing valve – is often offered to older stenosis patients, as it doesn’t require a general anaesthetic.
The downside is the calcium remains in place and once the new valve goes in it may press on fibres that send electrical messages to the heart – so the patient may need a pacemaker.
More severe cases may have valve-replacement surgery, where the existing valve is replaced. ‘It’s major surgery but the risk of death is less than 1 per cent,’ says Mr Aktuerk.
For Roger this was the only viable option because his valve was so diseased.
Being told, following his annual echocardiogram last August, he needed such major surgery came as a big shock. Roger recalls: ‘My consultant called me and said: “The time has come.”
‘But it didn’t really sink in until I got the hospital letter. I knew this needed to happen, but was I scared? Absolutely. I felt very vulnerable. The chance of me not waking up afterwards was less than 2 per cent – but that’s the bit I was scared of.’
He and Jules digested the news before telling their children: Isabelle, 25, and twins Max and George, 19, as well as a handful of friends.
During the six-hour operation at Spire Southampton Hospital (on the NHS), on 22nd January, surgeons replaced his diseased valve and replaced a section of thinned aorta with synthetic material.
He came round in intensive care 11 hours later to find himself on a ventilator, tubes coming ‘out of everywhere’ – and Jules by his side.
‘I was told that when they opened me up my valve was worse and my aorta thinner than they had expected,’ he says. ‘But each day another tube came out and I got a little better.’
On day two he shuffled 20 metres down the ward ‘and slumped back down in a chair exhausted’.
His biggest problem was lack of sleep, partly as his 6ft 3in frame didn’t fit well in a hospital bed, so it was ‘transformative’ to be back in his own bed eight days later.
He only managed a five-minute walk outside the next day, ‘but it was so good to breathe fresh air’.
Roger is taking paracetamol for pain from the 11-inch wound running down his chest, which is ‘painful but not terrible’.
He is also on an aspirin to prevent blood clots, statins to reduce raised cholesterol (discovered before the surgery) and a drug to control an erratic heart rhythm – a common complication of open-heart surgery (which he’s been told will be temporary).
He admits he has ‘felt emotional’ since the surgery and is fulsome in his praise of Jules, adding: ‘Without [her] I don’t know how I would have coped through this. She’s been amazing.’
Roger hopes to be discharged by his consultant soon and will then be back to annual echocardiograms. In around 15 years or so his valve will need replacing – next time via Tavi.
Roger adds: ‘I’m not fully recovered yet, so I don’t know how different I will be compared to before I had the surgery – I hope I don’t fall asleep in front of the TV anymore.’
He’s walking more every day and is soon to tackle hills, but when asked if he misses running, he says: ‘Oddly enough, I don’t.’
Visit heartvalvevoice.com for more information.
